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ASC Revenue Cycle 2021 & 2022 Forecast: 10 Things to Consider

Jessica Nelson

December 10, 2021 By Jessica Nelson

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Our Revenue Cycle Services team recently presented a webinar highlighting the trends, issues, and developments that impacted ASCs in 2021 and some trends likely to affect ASCs in 2022. Below is a recap of the webinar that ASCs can use to help plan for revenue cycle success in 2022.

SIS Revenue Forecast

We're approaching the end of 2021, which also means we're nearing the beginning of 2022. That makes it a good time for ASCs to look back and look forward. Below we identify 10 things ASCs will want to consider about the year that was and the year that will be, with a focus on revenue cycle trends and developments. We also pose some questions you may want to be asking yourself about these areas and how your ASC should respond.

5 Significant Developments From 2021

Here are five of the most noteworthy developments from 2021 that affected or will likely affect ASCs:

1. COVID-19 continues to disrupt operations

More than 18 months into the pandemic, the effects of COVID-19 on ASCs are still quite evident. From commercial payers still taking longer to reimburse for care, to patients struggling to cover their bills, to staff shortages, COVID-19 and its variants are creating daily challenges for surgery centers. Do you have strong processes and plans to navigate these obstacles that are likely to remain for some time?

2. CMS finalized significant changes to its procedure lists

The agency removed 255 of the 258 codes it had added to the ASC Covered Procedures List in 2021 and reinstated the inpatient-only list. Do you understand know how these changes may affect your ASC in the short and long term?

3. Surgical migration continues

We continue to see surgical cases migrating from the inpatient to the outpatient setting. These include higher-acuity cases in areas such as total joints, gynecology, and cardiology. Is your ASC in a position to capture this case volume?

4. OAS-CAHPS is back

CMS announced it intends to make ASC participation in the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS) mandatory beginning in 2025. Do you know what your ASC should be doing in preparation?

5. Colorectal cancer screening recommendations changed

In May 2021, the U.S. Preventive Services Task Force (USPSTF) issued new recommendations for colorectal cancer. USPSTF stated that people at average risk should start screening at age 45, reduced from 50. If your ASC has a gastroenterology/endoscopy program, what can you do to help build awareness of this change among referral sources and patients?

5 Things to Watch for in 2022

Here are five possible and probable developments for 2022 ASCs will want to watch and prepare for:

1. Payment challenges will remain

There's no reason to expect the challenges we're seeing around payment — both concerning payers (e.g., payment delays) and patients (e.g., payment struggles) — will resolve themselves in 2022. Do you have the processes and people in place to best ensure your ASC is getting paid what it's owed and in a timely manner?

2. KPIs will still feel COVID's effects

Some of the core ASC revenue cycle key performance indicators (KPIs) (e.g., A/R > 90, days in A/R, days to pay) are likely to continue lagging pre-COVID performance levels, with performance on some KPIs possibly getting worse. Is your ASC carefully monitoring its KPIs and prepared to respond quickly when performance looks to be heading south?

3. Payers will further embrace ASCs

With COVID continuing to linger, commercial payers will look for more opportunities to steer cases away from the inpatient hospital setting (the optimal place for "sick people") and into the outpatient setting, including ASCs. Are you prepared to present data and metrics to show payers why your ASC should get that case volume and what you need to be paid to make it financially worthwhile for your center to perform these procedures?

4. Competition will increase

With care continuing to move away from the inpatient environment and toward the outpatient environment, many ASCs are likely to face increased competition in 2022. We can expect to see more de novo (new) ASCs as well as hospitals and health systems getting more aggressive in developing hospital outpatient departments and acquiring ASCs. We can also expect ASCs with the ability and desire to grow to pursue such opportunities. All these factors will contribute to increased competition for cases/patients, physicians, payer contracts, and more. What are you doing to keep your ASC competitive in its market, and do you have plans to respond if competition increases?

5. Payers will push for more value-based care

While fee-for-service remains the dominant payment method for ASCs, value-based payment models (e.g., bundled payments) are on the rise. Commercial payers will likely pursue more of such contracts in 2022. Is your surgery center in a position to take advantage of this interest and negotiate appropriate contracts?


Learn More About ASC Revenue Cycle Trends and Developments

To learn more about these and other ASC revenue cycle trends and developments, check out our webinar titled "ASC Revenue Cycle 2021 Review and 2022 Forecast." It's now available on-demand and has been approved for up to 1.0 hours of AEU.

Topics: Revenue Cycle Management, Financial, ASC Solutions, Ambulatory Surgery Centers, Webinars

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