ACE Alert, September 23, 2021 Volume 39
ASA Managed Care Survey Released
The highly regarded ASA managed care survey for 2021 was just released this month. Stan Stead, MD, MBA, FASA and Sharon Merrick, MS, CCS-P survey anesthesia groups across the country for five of their largest commercial managed care contract conversion factors. The goal is to continue to update the anesthesia community with average contractual amounts and present a view of regional trends in commercial contracting.
Based on the 2021 ASA commercial conversion factor survey results, the national average commercial conversion factor was $85.23, ranging between $79.04 and $90.23 for the five contracts. The national median increased to $78.00, ranging between $74.00 and $81.50 for the five contracts. In comparison, in the 2020 survey, the mean conversion factor ranged between $76.09 and $85.75, and the median ranged between $69.00 and $77.25. So overall while small, 3-4% increase, it is an increase and is good news for anesthesia practices looking for support to negotiate an increase in unit rates.
It should be noted that the response to the survey included 219 practices in 47 states and the District of Columbia and is the most reliable anesthesia-specific information for managed care contracting. You can link to the ASA article here
It will be very interesting to watch and participate in the 2022 survey to see what effects, if any, will come from the out-of-network legislation that is set to begin in January 2022. Be sure to watch for the survey next summer and participate.
As always managed care contracting is just half of the equation. Making sure that you are getting paid what you have been contracted is essential in understanding the true net effective rate for the managed care contract. ACE has developed a specific audit process to assist your group with managed care reimbursement. If you would like additional information on a managed care reimbursement audit, please contact Kayla Lee at firstname.lastname@example.org.