Do you think there’s a way to advocate for legislation around this part “It’s the cumulative effect of opaque rate setting, downward pressure via surprise billing legislation, and structural underpayment of anesthesia services in many markets?” Is it that the bill in Illinois and elsewhere isn’t written well enough to capture points which could resolve the core issues? And what might legislation that was willing to address that look like?
Yes, but it’s tough. Most surprise billing laws were built to stop balance billing, not fix underpayment. For anesthesia, the “median in-network rate” anchors us to historically low reimbursements. A better law would require transparency, cost-based benchmarks, and regular updates tied to labor realities, but that takes political will, and so far, it’s been lacking.
It could, yes. ASCs aren’t inherently lower quality, but shortcuts in staffing or prep time add risk. With clinician shortages, the margin-for-error shrinks. If we don't protect care standards while scaling access, we’re setting ourselves up for avoidable failures.
Do you think there’s a way to advocate for legislation around this part “It’s the cumulative effect of opaque rate setting, downward pressure via surprise billing legislation, and structural underpayment of anesthesia services in many markets?” Is it that the bill in Illinois and elsewhere isn’t written well enough to capture points which could resolve the core issues? And what might legislation that was willing to address that look like?
Yes, but it’s tough. Most surprise billing laws were built to stop balance billing, not fix underpayment. For anesthesia, the “median in-network rate” anchors us to historically low reimbursements. A better law would require transparency, cost-based benchmarks, and regular updates tied to labor realities, but that takes political will, and so far, it’s been lacking.
Shortages of clinicians, ASCs historically focus heavy on profits...will this transition lead to lower quality of care?
It could, yes. ASCs aren’t inherently lower quality, but shortcuts in staffing or prep time add risk. With clinician shortages, the margin-for-error shrinks. If we don't protect care standards while scaling access, we’re setting ourselves up for avoidable failures.