04/06/2023

How ASCs are managing cash flow for high-cost implants

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While most ASCs are ultimately striving to deliver high-quality patient care with optimal outcomes, maintaining profitability is key to ensuring ASCs can do just that. According to a recent ASCA survey of 294 ASCs, 56% believe reimbursement and payer regulations will be the ASC industry’s biggest challenge in 2023. While this can be daunting for many independent ASCs, the industry is already evolving to help ASCs manage these challenges.

For many ASCs, this begins with negotiating appropriate reimbursement rates with contracted health plans. This can prove quite challenging for procedures involving implants, as the implant itself can be the highest and most variable procedural cost drivers, making it a vital factor in the success of an ASC that accepts implant procedures. A recent Becker’s article quoted an ASC Corporate Director identified several items that he concerned key to successful ASC management, with the first one being: “Fair payer contracts with the top three health plans most utilized in the service area that my ASC is in, with carve-outs for implants and a rate that provides a minimum contribution margin after accounting for all costs.”

Even if appropriate rates are negotiated with the health plan, a successful ASC must be mindful of cashflow, as procedural reimbursement can vary greatly. High-acuity implant procedures can often involve high-cost implants. Particularly with the increase in orthopedic procedures shifting to ASCs, a recent article from article from Medtech Dive describes how some manufacturers are creating financing plans for ASCs to help manage the cashflow burden that high-cost implant procedures can create.

Not many manufacturers offer financing, and navigating proper reimbursements can be challenge, especially without visibility to national data. IPG was born out of this need. IPG helps ASCs increase profitability by assisting ASCs in negotiating appropriate reimbursement rates and by normalizing cash flow. Using a carve out model, IPG directly pays manufacturers for the implant, or reimburses facilities for their implant costs within 30 days of the procedure. IPG works with more than 500 ASCs across the US, taking on the implant risk so their partnering ASCs can focus on delivering high-quality, affordable care to patients. Click here to learn more about IPG.