Becker's Healthcare March 3, 2025
Three ASC leaders joined Becker’s to discuss how reimbursement rates affect ASC operations
Question: How are shifting reimbursement rates affecting ASCs’ financial stability and case mix?
Editor’s note: Responses have been edited lightly for clarity and length.
Sean Hayes. President of the American Pain Consortium (Carmel, Ind.): While shifting reimbursement rates have been more favorable in some instances, the bigger risk lies in the shift in payer policies. Payers may offer higher headline rates, but those gains can be offset by arbitrary reimbursement policies and administrative processes. Increased denials, complex billing requirements and extended payment cycles all add to the operational burden. ASCs often face rising administrative costs in efforts to manage these challenges, which erodes overall financial stability....
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