ASC Economics: What Healthcare Leaders Get Wrong About Reimbursement

As more procedures migrate from hospitals to ambulatory surgery centers, the economics are becoming more complex, not less.

Mark Wainner, Sr. Director of ASC Acquisition and Development at Community Health Systems, joins the Healthcare Intelligence Podcast to unpack how ASC reimbursement, payer contracting, and health system partnerships are evolving.

Mark explains why comparing commercial contracts can be so difficult, how implant reimbursement and multi-procedure payment rules change the economics of a case, and why Medicare can still serve as a useful benchmark when evaluating payer rates.

The conversation also explores:

• Why hospital-ASC partnerships are no longer simply a “rate lift” strategy
• How to evaluate reimbursement at the case level, not just the CPT level
• The challenges of benchmarking commercial payer contracts
• How implant costs and reimbursement affect ASC margins
• Why physician alignment remains critical to ASC performance
• What healthcare leaders should expect as more procedures move outpatient

For CFOs, revenue cycle leaders, ASC executives, and health system operators, this conversation offers a practical look at the financial forces shaping the next phase of outpatient care.

Guest: Mark Wainner, Sr. Director, ASC Acquisition and Development, Community Health Systems