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Patterns the USPSTF recommendations. “This new case volume will to base their site-of-service decision,” Lambiasi says. “This plays largely go to surgery centers,” Lambiasi says. “If hospitals to one of the core strengths of ASCs: lower costs.” want to see these patients within their service lines, it’s time The “No Surprises Act,” which took effect in 2022, may to start thinking about an ASC strategy.” further spur consumerism, he adds. Commercial payor preference. The pandemic has motiFederal initiatives. When looking at some of the major vated commercial payors to consider and adopt site-of-service federal developments of the past decade, Lambiasi is reminded policies that are more aggressively pushing patients out of of Steven Brill’s Time magazine article, “Bitter Pill: Why Medithe inpatient setting. “Payors are requesting more documencal Bills Are Killing Us.” tation from hospitals to authorize procedures and prove that “Consider recent efforts to push consumerism, such as accountable care organizations, various Affordable Care Act the hospital is an appropriate site of care,” Lambiasi says. “It’s becoming much more difficult for hospitals to receive approval initiatives, the exchanges and transparency laws,” he says. for something like a screening endoscopy for a younger, health- “I think CMS and the federal government are trying to avoid more sticker shock to patients.” ier patient. These cases are going to ASCs.” Lambiasi believes there will be more In 2021, the U.S. Preventive Ser“If hospitals want to see similar initiatives down the road. “We vices Task Force (USPSTF) issued new already have site neutrality for some recommendations for colorectal cancer [patients under age 50] surgical procedures where the hospital and stating that people at average risk should within their service lines, ASC are paid the same rate. Are screening start screening at age 45 instead of the endoscopies or other elective GI cases ripe traditional 50. The Affordable Care Act it’s time to start thinking for site neutrality? If a development like requires most insurers to cover the costs about an ASC strategy. ” this occurs and you’re a hospital lacking of colorectal cancer screening tests as per
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