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BackTable / VI / Podcast / Episode #287

OBL / ASC Reimbursement Update Jan 2023

with Dr. Jim Melton and Dr. Blake Parson

In this episode, host Dr. Aaron Fritts interviews Dr. Jim Melton, vascular surgeon, and Dr. Blake Parsons, interventional radiologist, about progress in the OBL and ASC space, including reimbursement updates, partnering with a private equity firm, and value based care.

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OBL / ASC Reimbursement Update Jan 2023 with Dr. Jim Melton and Dr. Blake Parson on the BackTable VI Podcast)
Ep 287 OBL / ASC Reimbursement Update Jan 2023 with Dr. Jim Melton and Dr. Blake Parson
00:00 / 01:04

BackTable, LLC (Producer). (2023, January 30). Ep. 287 – OBL / ASC Reimbursement Update Jan 2023 [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Jim Melton discusses OBL / ASC Reimbursement Update Jan 2023 on the BackTable 287 Podcast

Dr. Jim Melton

Dr. Jim Melton is a practicing Vascular Surgery Specialist in Oklahoma City.

Dr. Blake Parsons discusses OBL / ASC Reimbursement Update Jan 2023 on the BackTable 287 Podcast

Dr. Blake Parsons

Dr. Blake Parsons is a practicing Interventional Radiologist in Oklahoma City.

Dr. Aaron Fritts discusses OBL / ASC Reimbursement Update Jan 2023 on the BackTable 287 Podcast

Dr. Aaron Fritts

Dr. Aaron Fritts is a Co-Founder of BackTable and a practicing interventional radiologist in Dallas, Texas.

Show Notes

We begin by discussing new developments in Dr. Melton’s and Dr. Parson’s practice. Over the past year, they have partnered with a private equity firm, Assured Healthcare Partners to create Heart and Vascular Partners (HVP). They now cover Oklahoma City, Colorado Springs, Denver, Pueblo, and parts of Illinois and Indiana. They employ mostly hospital based physicians’ ready to start their own office based lab (OBL) or ambulatory surgery center (ASC). The physicians under HVP are cardiologists, vascular surgeons, and interventional radiologists.

The two discuss the advantages of aligning with a private equity firm. For them, it provided the scale and capability to provide value-based care when it becomes widely adopted. Additionally, the payer has a much lower cost for the service in the outpatient space versus the hospital. All the physicians in HVP maintain local control over their practices, which was one of their main goals when they decided to partner with a firm.

Next, we cover reimbursement cuts and the trends in OBLs and ASCs. On the arterial side of business, they are seeing that OBLs are down 10-15% in reimbursement rates, whereas ASCs are up 3-30%. For iliac interventions in the ASC, they have seen a 30-50% increase in balloon angioplasty and stenting, and up to a 60% increase for Shockwave. On the embolization side, arterial and venous reimbursement has dropped in the OBL by 7-8% and increased in the ASC by 3-30%. Alternatively, the CPT code for embolization for end organ ischemia (UFE, PAE) is still well reimbursed in the OBL. They caution listeners on genicular artery embolization and cryoneurolysis due to the risk of not getting it reimbursed and having to pay money back.

Resources

Heart and Vascular Partners:
https://heartandvascularpartners.com

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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