Four trends are gaining traction as the healthcare industry approaches the year 2020 and the industry’s transformation to value-based care positions hospitals, physicians, and ASC partners to accelerate ambulatory strategies. The latest white paper from Regent Surgical Health titled “OUTPATIENT ACCELERATION: 4 Trends Shaping Ambulatory Growth in 2020” outlines developments pushing the industry faster and faster in the outpatient direction.
- Outpatient Total Joint Replacement
Fueled by proposed Centers for Medicare & Medicaid Services (CMS) 2020 policies for outpatient and ASC payments, growth in outpatient total joint replacement is the first key trend. The updated policies include total knee arthroplasty on the covered procedures list for ASCs and remove total hip arthroplasty from the “inpatient only” list. The goals of the new policies are at the core of value-based care: Increase price transparency, reduce provider burden, and help both hospitals and ambulatory surgery centers operate with better flexibility, giving patients the options they need to become active healthcare consumers.
“These proposed policies will wake up joint surgeons who have been more than happy to do all their total joint cases in the more expensive hospital, creating an expectation that appropriate cases move more aggressively outpatient, and leaving the hospital for patients who truly need additional services,” says Regent’s Director of Bundled Payments Chris Stine.
- Physician Practice Partnerships and Acquisitions
With 7.5% consolidation among independent doctors in each of the past four years, the trend toward large physician’s practice partnerships has been well documented and is expected to continue at an accelerated pace as health systems, payors, private equity, and large medical groups continue their buying spree. In addition to independents, smaller groups (2-3 physicians) will likely also continue to be acquisition targets because they often lack the resources to meet the requirements of value-based care programs. Larger groups, on the other hand, will enjoy a variety of options ranging from purchase to partnership.
- Hospital Physician Alignment Strategy
In a reversal from previous years, more hospitals will choose to share ownership with physicians in ASCs, profiting from the move of lower acuity, lower reimbursing cases to the outpatient setting while freeing up inpatient operating rooms for higher acuity, higher reimbursing cases. Unheard of just two years ago because ASCs are paid on average 53% of the hospital in-patient or HOPD rate for Medicare patients, this shift takes into account the lower costs, better outcomes, patient convenience, and physician preference of the outpatient setting.
“As health systems move toward deriving greater percentages of revenue from value-based care, the potential for higher reimbursement in the hospital or an HOPD is outweighed by the advantages of leveraging a broader ambulatory platform. Mathematically, moving in the opposite direction doesn’t make sense anymore,” says Regent CEO Chris Bishop.
- Technology/Expertise Drive Center Financial Performance
Finally, in 2020, more ASCs will embrace technologies and strengthen focus to improve the lifeblood of their business – revenue cycle. From a technology point of view, data collection helps identify issues with turnover times or on-time starts, centers have significantly reduced day of service cancellations with electronic form gathering and notifications, and materials management software has improved the speed and accuracy of ordering and inventory.
In addition, Regent has developed ASC-specific revenue cycle measurement tools and benchmarks to help centers gain a better handle on their financial health. Centers using the benchmarks are seeing significant improvement. For example, The Center for Specialized Surgery in Ft. Myers saw collections increase $125,000 per month in the past year after implementing a new technology-supported process defined by Regent.
“Best practices in this area can increase revenue as much as 10-15%,” says Erin Petrie, Senior Director of Regent Revenue Cycle Management.
For additional information on each of these 2020 trends or to learn more about how Regent is helping prepare ASCs for the challenges and opportunities ahead, contact Thomas Crossen at firstname.lastname@example.org.