Outpatient Surgery Magazine

Obamacare, You're Fired - December 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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what? Per our process, we pay anesthesia a rate of $500 the first hour and $100 for each additional 15 minutes. Of the remaining collections, the facility and physician share is based on the amount of supply intensity, but usually breaks out at 55-60% to the facility and 40-45% to the surgeon. So for a $1,500, 1-hour case, the breakdown would look like this: $550 for the facility, $500 for anesthesia and $450 for the sur- geon. For price transparency to work, it's critical to collect from patients on the day of surgery so that you can reimburse your anesthetists and sur- geons that day or the next day. You want zero days in AR so you don't spend months chasing money from patients (see "Get Patients to Pay in Full on the Day of Surgery" at osmag.net/ZxWt5K). Many people are concerned with how you handle costly implants, specifically when you don't know how much will be used. We charge our patients our invoice cost as an add-on to the facility fee. To let patients know there'll be an extra cost after the case, we add an aster- isk to implant cases on our online pricing menu. It would be ideal to incorporate implants into the bundled price, but we don't always know what implants we'll use until after the case. If you underesti- mate implant usage on a rotator cuff repair, for example, where anchor use can vary significantly, you'll likely lose money. We've explored the idea of folding implant costs into our online prices and refunding patients if we end up using less than we'd anticipated. (You never want to come at patients a second time to ask for money.) An unintended benefit of price transparency is that your surgeons might become more keenly aware of their supply and implant costs. If they see a colleague producing similar outcomes with lower case costs, they might be motivated to economize themselves. D E C E M B E R 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 3 1

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