A Historic Beginning to a Great Partnership

The health plan representatives stated that the future focus will be on consumer driven health plans and the new Medicare products that are emerging. They discussed the need for publicly-reported information. Mack relayed that the ASC industry has the data the health plans are looking for and would be willing to provide it to them. It was suggested that the health plans create some stakeholder groups to look at the data to be reported and the information posted on the Web sites.

Docherty again reported the history of CASA’s legislative activity over the past two years and Blakeley summarized CASA’s membership and history.

Leggett and Todorovich lead the discussion with the health plans and ASC corporate attendees. Specific discussions included: implant carve-outs and contract barriers from the health plan prospective; unlisted or new procedures that are safely being transitioned to ASCs; out-of-network issues and the stumbling blocks for those ASCs unable to get contracts; keeping pace with new technology; developing plan upgrade options for patients; and co-marketing ideas on the value of ASCs.

The health plans representatives were very engaged in the discussions and stated that they were open to ongoing, pointed discussions on new ideas and better ways to work together. All the plans indicated they were expanding their ASC networks. It was suggested to have a follow up meeting with individual health plans and their personnel that negotiate the ASC contracts to educate them on the industry changes and the ASCs, including new technologies and procedures.

Leggett closed the meeting with a suggestion that CASA develop a white paper addressing the Summit discussions. This proactive meeting organized by CASA was not only a productive and positive experience for all attendees, but felt to be a historic beginning to a great partnership between the health plans and CASA. New relationships were established and there was renewed energy to continue working towards positive outcomes for healthcare and the ASC industry.

CASA is diligently following up on the discussion outcomes and plans to continue moving forward, working towards positive results for its members and the ASC industry as a whole. This was a total WIN-WIN event for CASA and the California health plans.

Beth LaBouyer, is the executive director of CASA. She can be reached at blabouyer@sbcglobal.net.