ASCs play a critical role in healthcare delivery—offering safe, efficient, and lower-cost alternatives to hospital-based surgery. Yet despite their value, many ASCs are hitting a wall when negotiating in-network contracts with commercial insurance providers.
At Advanced Ambulatory Surgery Center, and across the industry, we’ve seen a
troubling trend: reimbursement rates offered to ASCs are significantly lower than
those extended to hospitals for the exact same procedures. In some cases, payers
present contracts that fall below the ASC’s cost of care, making them financially
unsustainable. This discrepancy raises a fundamental question: If ASCs save money and improve outcomes, why aren’t payers offering equitable reimbursement?
Hospitals often negotiate as part of large health systems with leverage across
multiple service lines and geographies. ASCs—particularly independent or
physician-owned centers—rarely have this scale, putting them at a disadvantage
when trying to establish fair in-network agreements. Meanwhile, patients are caught in the middle. Many are forced to choose between higher out-of-pocket costs or forgo care at high-performing ASCs that remain out-of-network. The result is a healthcare system that fails to reward efficiency and restricts access to high-quality, cost-effective care.
As our industry continues to push toward value-based care, commercial payers
must recognize the strategic and financial value ASCs bring. It’s time to level the
playing field in contract negotiations. Until that happens, the very facilities driving innovation, quality, and affordability in outpatient surgery will remain underutilized—an outcome that ultimately hurts patients, providers, and the payers themselves.
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