Single Specialty ASC

[painisfear]

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I am wondering if any of you are owners in your own single specialty ASC.

Would any of you be willing to chat or share advice or resources?

 

[pmrmd]

Sent you a PM

 

[gdub25]

I own an ASC, single specialty, and sold another one. Happy to chat.

 

[painisfear]

Thank you both

 

[Malayil]

I am part owner in a surgery center and a/p application for a single specialty ASC now set for a hearing to fight ‘affected parties’

 

[hyperalgesia]

I own an ASC, single specialty, and sold another one. Happy to chat.

Did you need a CON?

 

[mickey1t]

Would love to learn more about this…the idea always comes up of building out our own asc adjacent to the office for FFS procedures while keeping the office for EM visits and capitated payers but have had a hard time finding legitimate information about the nuts and bolts….does this make sense? what’s the smallest square footage necessary to make it work?

 

[gdub25]

I'd be happy to do a zoom call over this. I have a fair amount of experience having built several. In the design stage now of a new one.

 

[thecentral09]

I'd be happy to do a zoom call over this. I have a fair amount of experience having built several. In the design stage now of a new one.

Very interested in a call if completed! Thank you

 

[mickey1t]

Very interested in a call if completed! Thank you

I’d definitely listen in

 

[Status Sciaticus]

I'd be happy to do a zoom call over this. I have a fair amount of experience having built several. In the design stage now of a new one.

make it one of the usual monthly meeting conversations

 

[gaschicago]

Pain still profitable in ASCs? Surgeons are claiming in near future SOS will impact facility fee and thus recommend to keep it in clinic. Wanted to hear thoughts?

 

[nvrsumr]

@drusso has been claiming sos will be leveled 😂

Follow the $. In office cuts for years. Asc $ increases every year. As a pe suitor told me -competition for asc is hospital not office
Maybe musk and Kennedy fix. Doubtful

 

[drusso]

@drusso has been claiming sos will be leveled 😂

Follow the $. In office cuts for years. Asc $ increases every year. As a pe suitor told me -competition for asc is hospital not office
Maybe musk and Kennedy fix. Doubtful

SOS is the root of all evil in our health care system.

 

[Dr. Ice]

I personally can’t stand going to my own asc and dealing with all the nonsense that myself and the patients have to deal with. Would love to keep it all in office. SOS should absolutely go away for everyone’s sake

 

[Ducttape]

SOS is the root of all evil in our health care system.

still cant see the forest for the trees....

irrespective of my opinion of SOS fees, getting rid of SOS will do absolutely nothing for our healthcare system woes.

 

[drusso]

still cant see the forest for the trees....

irrespective of my opinion of SOS fees, getting rid of SOS will do absolutely nothing for our healthcare system woes.

I've lived it for well over a decade:

Healthcare Reform Creates Provider Monopolies | The Lund Report

www.thelundreport.org

"Thus, a key driver of consolidation has been “reimbursement arbitrage--” schemes to extract higher payment for services that could be delivered in lower cost or less resource-intensive settings. We’ve seen many, many times that when independent physician practices are acquired by hospitals, three things happen: Prices go up after the acquisition, total spending goes up, and referral patterns change. Hospitals pay the physicians and their staff the same salaries, but charge more for these services in their Hospital Outpatient Departments (HOPD’s), and pick up this additional revenue without adding value."

 

[Ducttape]

for just a decade?

healthcare system woes have been going on for decades with an s at the end...

 

[drusso]

for just a decade?

healthcare system woes have been going on for decades with an s at the end...

Face it: If you're not part of the solution, you're part of the problem (juicing the Vig on SOS).

Opinion: Fair reimbursement rates can bring down health care costs for Oregonians, including in rural areas | The Lund Report

Congress should halt the practice of paying hospitals more than independent practices for the exact same procedures — which is driving a costly surge in consolidation — and adopt site-neutral payment reforms

www.thelundreport.org

"The solution is clear: we need site-neutral payment policies to ensure that patients, no matter where they live or what facility they visit, aren’t overcharged for their health care. It’s a common-sense, bipartisan approach that would reduce the cost of care, especially for rural patients, and help prevent more Americans from falling into the trap of medical debt.

As a physician, I believe it is our duty to advocate for changes that protect patients and ensure that everyone, regardless of their location or financial status, can access the care they need. It’s time to end the practice of charging more for the same care simply because of where it’s provided. Site-neutral payments are the first step in making health care fairer, more affordable, and more accessible for all."

 

[SSdoc33]

I've lived it for well over a decade:

Healthcare Reform Creates Provider Monopolies | The Lund Report

www.thelundreport.org

"Thus, a key driver of consolidation has been “reimbursement arbitrage--” schemes to extract higher payment for services that could be delivered in lower cost or less resource-intensive settings. We’ve seen many, many times that when independent physician practices are acquired by hospitals, three things happen: Prices go up after the acquisition, total spending goes up, and referral patterns change. Hospitals pay the physicians and their staff the same salaries, but charge more for these services in their Hospital Outpatient Departments (HOPD’s), and pick up this additional revenue without adding value."

continually posting and re-posting the article for which you yourself are the author doesnt really move the needle.

nobody doubts that SOS (d) does drive increase costs.

but you are like the Scots squabbling for the scraps from Longshank's table.

by FAR, the biggest cost is private insurance. they take 1/3 right off the top. and the only function is to administer plans that CMS puts out the rules for. it is simply an added cost. i understand that we dont want to increase the size or power of the gvt, but in this case the only thing that blue cross, united, and cigna do is make things cost more. those administrators and CEOs are raping the system. its not the HOPD doc seeing medicaid patients. its not the hospital administrator or MBA (although they are a smaller problem as well).

what you will get if you make payments site-neutral is that everyone will get paid at medicaid rates (or worse).

best option is to eliminate private coverage as we know it. every citizen gets a really crappy, preventative-based, medicaid-like coverage. then, if you have the means, you buy the cadillac plan. the key to this is that the plan for everyone needs to be really sh$tty and cheap b/c we (the taxpayers) will be paying for it.

 

[drusso]

continually posting and re-posting the article for which you yourself are the author doesnt really move the needle.

nobody doubts that SOS (d) does drive increase costs.

but you are like the Scots squabbling for the scraps from Longshank's table.

by FAR, the biggest cost is private insurance. they take 1/3 right off the top. and the only function is to administer plans that CMS puts out the rules for. it is simply an added cost. i understand that we dont want to increase the size or power of the gvt, but in this case the only thing that blue cross, united, and cigna do is make things cost more. those administrators and CEOs are raping the system. its not the HOPD doc seeing medicaid patients. its not the hospital administrator or MBA (although they are a smaller problem as well).

what you will get if you make payments site-neutral is that everyone will get paid at medicaid rates (or worse).

best option is to eliminate private coverage as we know it. every citizen gets a really crappy, preventative-based, medicaid-like coverage. then, if you have the means, you buy the cadillac plan. the key to this is that the plan for everyone needs to be really sh$tty and cheap b/c we (the taxpayers) will be paying for it.

What are YOU doing about it?

 

[hyperalgesia]

continually posting and re-posting the article for which you yourself are the author doesnt really move the needle.

nobody doubts that SOS (d) does drive increase costs.

but you are like the Scots squabbling for the scraps from Longshank's table.

by FAR, the biggest cost is private insurance. they take 1/3 right off the top. and the only function is to administer plans that CMS puts out the rules for. it is simply an added cost. i understand that we dont want to increase the size or power of the gvt, but in this case the only thing that blue cross, united, and cigna do is make things cost more. those administrators and CEOs are raping the system. its not the HOPD doc seeing medicaid patients. its not the hospital administrator or MBA (although they are a smaller problem as well).

what you will get if you make payments site-neutral is that everyone will get paid at medicaid rates (or worse).

best option is to eliminate private coverage as we know it. every citizen gets a really crappy, preventative-based, medicaid-like coverage. then, if you have the means, you buy the cadillac plan. the key to this is that the plan for everyone needs to be really sh$tty and cheap b/c we (the taxpayers) will be paying for it.

If you would be willing to do your suggestion on a state opt in basis, I'd be on board. Probably many conservatives would support. But not on a national level.

 

[SSdoc33]

What are YOU doing about it?

Me?

I'm juicing the vig on the SOS, baby!

 

[SSdoc33]

If you would be willing to do your suggestion on a state opt in basis, I'd be on board. Probably many conservatives would support. But not on a national level.

id wouldnt work on a voluntary basis. and it wouldnt work on a state-level only basis. herein lies the problem.

 

[drusso]

Me?

I'm juicing the vig on the SOS, baby!

 

[hyperalgesia]

id wouldnt work on a voluntary basis. and it wouldnt work on a state-level only basis. herein lies the problem.

Why not?

 

[SSdoc33]

View attachment 395435

 

[SSdoc33]

Why not?

system is too big to change on the fly like that. too many moving parts.

it has to be a federal mandate or we survive in the model we have. im not sure which is better. probably the status quo, but id like to see less of the pie go to insurance and pharma/devices.

 

[hyperalgesia]

system is too big to change on the fly like that. too many moving parts.

it has to be a federal mandate or we survive in the model we have. im not sure which is better. probably the status quo, but id like to see less of the pie go to insurance and pharma/devices.

I'm the gov of CA and I'm proposing a combined Medicare Advantage/Medicaid system that patients can opt into vs Trad Medicare or Medicaid. The money my state gets for these programs will be used to fund a Canadian style system in California.

There is no added cost and pts will continue to have the option to remain on their traditional programs.

Basically this is a new type of Medicare Advantage that covers everyone - universal, basic, healthcare.

 

[SSdoc33]

I'm the gov of CA and I'm proposing a combined Medicare Advantage/Medicaid system that patients can opt into vs Trad Medicare or Medicaid. The money my state gets for these programs will be used to fund a Canadian style system in California.

There is no added cost and pts will continue to have the option to remain on their traditional programs.

Basically this is a new type of Medicare Advantage that covers everyone - universal, basic, healthcare.

again. too many moving parts. cant be handled by a single state. what happens when someone come if from out of state? what happens when a californian gets medical care in nevada? where are the rates set? whats the difference between medicare, medicare advantage, medicaid, and the new "Calicare" program. why would people opt-in if they are medicare-elegible?

this is a half-measure that feels a lot like the exchange programs with the ACA. its not gonna do anything, but create a lot of headaches, and we wont know the results of the experiment for a decade (and thats if it works).

there needs to be some pain if this is going to be sustainable. we should get rid of traditional medicare (i know, never gonna happen), but then slowly make it so crappy that you need to buy supplemental insurance to get brand name drugs, immediate access to specialists, and MRIs at will. this isnt ideal, but it is better than the system we have now fom a public health perspective.