National Medical Billing Services

06/28/2024 | Press release | Distributed by Public on 06/28/2024 08:01

Top Takeaways from Becker’s 21st Annual Orthopedic, Spine, and Pain Management ASC Conference

Top Takeaways from Becker's 21st Annual Orthopedic, Spine, and Pain Management ASC Conference

The nimble team, pictured with Jerry Rice

Becker's 21st Annual Orthopedic, Spine, and Pain Management ASC Conference held in Chicago was a hub of insights, trends, and transformative ideas for Ambulatory Surgery Centers (ASCs). Industry leaders, experts, and healthcare professionals gathered to share their knowledge and discuss the future of ASCs in an ever-evolving healthcare landscape.

As industry leaders in ASC revenue cycle management, here are nimble's biggest takeaways from this year's conference.

1. ASCs Provide Better Care at a Lower Cost

One of the most significant advantages of ASCs is their ability to deliver high-quality care at a lower cost compared to traditional hospital settings. By focusing on specialized procedures and streamlining operations, ASCs can reduce overhead and pass those savings on to patients. This efficiency not only helps in managing healthcare costs but also ensures that patients receive timely and focused care tailored to their specific needs.

The conference highlighted the commitment to continuous improvement in care, quality, and cost-effectiveness. Speakers discussed various strategies employed by successful ASCs such as how to build strong relationships with payers and health systems and how to improve reimbursement through a specialized approach to coding, billing, and managed care contracting.

By prioritizing these areas, ASCs are exceeding the standards set by traditional healthcare facilities, proving that high-quality care does not have to come with a high price tag.

One of the most significant advantages of ASCs is their ability to deliver high-quality care at a lower cost compared to traditional hospital settings. By focusing on specialized procedures and streamlining operations, ASCs can reduce overhead and pass those savings on to patients. This efficiency not only helps in managing healthcare costs but also ensures that patients receive timely and focused care tailored to their specific needs.

The conference highlighted the commitment to continuous improvement in care, quality, and cost-effectiveness. Speakers discussed various strategies employed by successful ASCs such as how to build strong relationships with payers and health systems and how to improve reimbursement through a specialized approach to coding, billing, and managed care contracting.

By prioritizing these areas, ASCs are exceeding the standards set by traditional healthcare facilities, proving that high-quality care does not have to come with a high price tag.

2. Growth of Orthopedic Services in ASCs

Advances in medical technology and minimally invasive surgical techniques make it possible for more complex orthopedic procedures to be performed safely in an outpatient setting. ASCs are increasingly becoming the go-to option for procedures like joint replacements, arthroscopies, and spinal surgeries. While the COVID-19 pandemic accelerated case migration, the trend continues to evolve as CMS approves more procedures for the ASC setting.

On the Becker's Healthcare Podcast recorded during the conference, Andy Ball, executive director for ASC operations for Cedars-Sinai, shared that their Beverly Hills ASCs saw a significant increase in spine surgeries, growing from 100 to 800 fusions annually during the pandemic. This shift not only helped patients but also integrated ASCs more closely with health systems, proving their ability to deliver quality outcomes.

Today, ASCs continue to play a crucial role in alleviating the burden on hospitals overwhelmed with the surgical needs of the aging population. The shift from in-patient to outpatient is driven by patient preference for shorter hospital stays, quicker recovery times, greater specialization, and cost savings. Payers are also looking to reduce the costs for medical procedures, particularly for orthopedics.

3. How Staffing Shortages Impact ASCs

The healthcare industry has been facing staffing shortages, and ASCs are not immune to these challenges. During the Big Headwinds for Orthopedic, Spine ASCs and What to Do Next panel discussion, panelists shared their concerns with the shortage of interventionalists and anesthesia providers in the market.

In terms of interventionalists, panelists agreed that not all pain fellowships are alike. Capabilities within the specialty and the caliber of each interventionalist depends on the training received, which can make hiring the right interventionalists for the ASC setting challenging.

The demand for skilled anesthesiologists and nurse anesthetists has led to increased competition for these professionals. This shortage can impact the scheduling and availability of procedures, potentially causing delays and limiting the ASC's capacity to serve patients.

Panelists discussed the pros and cons of relying on MD anesthesiologist to fill the role of CRNAs and the challenges with anesthesia reimbursement. Various strategies to mitigate these issues included discussing whether to bring anesthesia in-house instead of relying on the availability of anesthesia providers from anesthesia groups

4. The Role of Data and Analytics

Data and analytics are pivotal in navigating the complex healthcare environment. The conference underscored the importance of leveraging robust data management tools to gain insights into revenue, patient outcomes, and operational efficiencies.

Effective use of data analytics enables ASCs to make informed decisions. By analyzing financial data, ASCs can identify trends, optimize billing processes, and improve revenue cycle management. This not only ensures financial sustainability but also allows for strategic investments in technology and staff.

Patient outcome data is equally crucial. By tracking and analyzing outcomes, ASCs can pinpoint areas for clinical improvement, tailor treatment plans, and ensure the highest standards of patient care. This data-driven approach supports evidence-based practices, leading to better patient satisfaction and reduced complication rates.

Operational efficiencies can also be significantly enhanced through data analytics. By examining workflow patterns, resource utilization, and scheduling efficiency, ASCs can streamline operations, reduce wait times, and enhance staff productivity. This leads to a more efficient, patient-friendly environment.

In addition to internal benefits, data and analytics help ASCs demonstrate value to payers and regulators. By providing concrete evidence of cost savings, improved outcomes, and operational excellence, ASCs can advocate for better reimbursement rates and favorable policy changes.

5. Collaboration with Health Systems

A recurring theme was the trend in fostering strong collaborations between ASCs and health systems. By working closely with primary care physicians, specialists, and rehabilitation services, ASCs can ensure a seamless continuum of care for patients. These collaborative care models improve patient outcomes and enhance the overall efficiency and effectiveness of the healthcare system.

Strong collaborations facilitate better care coordination, timely referrals, and shared access to patient records, which are critical for managing patients with complex needs. Moreover, these partnerships allow for the sharing of best practices, resources, and innovations, leading to higher standards of care across all settings.

Additionally, collaborative relationships between ASCs and health systems can help address challenges such as patient transitions and follow-up care. By ensuring that patients receive the necessary support and resources throughout their care journey, from initial consultation to post-operative rehabilitation, these partnerships can significantly enhance patient satisfaction and recovery.

6. Adapting to Evolving Payer Policies

Conference sessions emphasized how ASCs can build strong relationships with payers, stay current on policy changes, and advocate for fair reimbursement practices.

Reimbursement remains a critical challenge for ASCs, particularly with the introduction of new technologies like robotics. While these technologies significantly enhance patient outcomes by increasing precision and reducing recovery times, they come with high costs and currently lack additional reimbursement codes from payers. This discrepancy creates a financial burden for ASCs that are early adopters of advanced surgical technologies.

For instance, recent challenges around receiving Medicare reimbursements for procedures such as total shoulder, total hip, and total knee replacements further highlight the financial downsides of integrating robotics when the overall costs overshadow potential reimbursement.

ASCs should invest in robust billing and coding teams and have a thorough understanding of their managed care contract terms to ensure accurate and timely reimbursement.

7. Human Element in Revenue Cycle Management

While technology is essential, the human element in revenue cycle management cannot be overlooked. Successful ASCs combine technological solutions with a dedicated team of revenue cycle experts who understand the nuances of coding, billing, and payer negotiations. Building strong partnerships with revenue cycle management firms ensures ASCs can navigate complex payer landscapes and maintain financial stability.

Final Takeaways from the 2024 Becker's 21st Annual Conference

Becker's 21st Annual Orthopedic, Spine, and Pain Management ASC Conference highlighted the dynamic nature of the ASC industry and the innovative strategies being employed to navigate its challenges.

By leveraging data, fostering partnerships,, and adapting to evolving payer policies, ASCs can continue to thrive and provide high-quality, cost-effective care.

For more insights from ASC industry leaders, listen to this Becker's Healthcare Podcast episode recorded at conference, featuring nimble's CEO Kelley Blair and Andy Ball, Cedars-Sinai's Executive Director for ASC Operations.