Category: ASC Coding, Billing and Collections

The Medicare Advantage market in 2023: 5 things to know

The American Medical Association has identified the insurance industry giants with the largest shares of the commercial health insurance, Medicare Advantage and public health exchange markets in 2023. 

MedPAC urges physician pay increases: 3 things to know

MedPAC is urging Congress to increase Medicare pay in its 2025 payment update recommendations drafted Dec. 8. 

Amazon, CVS Health and Optum: How the big 3 took on value-based care in 2023

Amazon, CVS Health and Optum are no strangers to value-based care. Here’s how they dug deeper into the model in 2023: 

The physician specialties that charge the most 

Cardiac surgeons are the physician specialty with the highest average charges, according to a November report from Definitive Healthcare. 

What procedures should be added to the ASC payables list?

The ASC payable list from CMS has seen sizable change in the last five years — but has it been enough to allow ASCs to thrive?

Adventist Health cuts ties with Blue Shield of California

As of Dec. 1, Roseville, Calif.-based Adventist Health will no longer accept Blue Shield of California insurance plans. 

Why ASC leaders have their eyes on Medicare reform

In November, CMS announced plans to reduce overall physician pay by 1.25% in 2024 and update the conversion factor to $32.74, a 3.4% decrease over last year, much to the chagrin of physicians and ASC leaders alike. 

HOPDs vs. ASCs: 10 considerations for 2024

ASC leaders are becoming increasingly frustrated with the reimbursement disparity between hospital outpatient departments and surgery centers.

5 stats to know on value-based care

Here are five statistics on the adaptation, popularity and potential benefits of value-based payment models to provide insight for ASC leaders:

Baptist Health confirms split from United, Wellcare Medicare Advantage plans

Louisville, Ky.-based Baptist Health will officially cut ties with UnitedHealthcare and Wellcare’s Medicare Advantage plans beginning in January, according to a Nov. 30 report from Louisville Public Media.