Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

2015 ASA Commercial Payer Survey Results

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The American Society of Anesthesiologists (ASA) recently released their 2015 ASA Commercial Conversion Factor survey results. Overall, the average commercial conversion factor was $71.92 nationwide, ranging between $69.64 and $74.29 for respondents’ top five commercial contracts. The national median was $68.00, ranging between $65.00 and $69.00 for the five contracts.

The survey was disseminated in June 2015 asking providers to report conversion factors of their top five commercial contracts, the percentage of total patient volume each contract represents, and basic demographic information. The 183 practices who responded employ or contract with the following: 4,672 full-time equivalents physician anesthesiologists, 3,838 FTE nurse anesthetists, and 493.1 FTE anesthesiologist assistants. As well, those practices work with the following additional staff who are not directly employed by them: 786.6 FTE nurse anesthetists and 25 FTE AAs. Respondents reported data on a total of 789 managed care contracts.

In last year’s 2014 survey, the mean conversion factor ranged between $66.98 and $71.79, which means the national average conversion factor range increased by close to $2.50 on both ends. Also, the 2014 median ranged between $63.88 and $69.00, which means the lower end of the median conversion factor range increased by more than $1 over the past year.

By way of comparison, the 2015 national Medicare conversion factor for anesthesia services was $22.4968 (January 1-June 30) and $22.6093 after July 1, 2015, which is about 31 percent of the 2015 overall mean commercial conversion factor.

A few other interesting findings from the survey:

  • more groups reported that payers offered them flat fee contracts for certain procedures.
  • One hundred thirteen of the 183 groups (61.7 percent) negotiated at least one flat fee contract, a 10 percent increase over 2014.
  • More than 5 percent of the respondents have flat fee contracts for labor and delivery.
  • Conversion factors are similar across different regions of the country, but the Eastern Region still has the highest mean of $77.96.
  • Every region and nearly every contract category had a conversion factor high of at least $82.00.
  • The highest conversion factor reported was $195.00.

Now that you have this updated data, how can you use it to manage your anesthesia practice?

Benchmark Your Practice

Use these numbers to compare your own reimbursement. The full report (download here) breaks down the numbers by region and state. How do you compare to other practices in your region?

Negotiate Your Contracts

Are you getting reimbursed fairly as compared to other anesthesia practices? If not, use this data to help you renegotiate your contracts with in-network payers. For payers that are reimbursing at lower rates compared to your own payer mix, provide redacted reports showing how they compare with other major payers in your area.

Update Your Charge Master

Not only do these conversion factor averages help you negotiate for greater reimbursement from your contracted plans, they can also help you ensure your charge master is in line with industry averages. When is the last time you evaluated or updated your per unit charge amount? Don’t leave money on the table by undercharging for your services.

Curious to learn more about how you can harness the power of payer information to improve your bottom line? Contact CIPROMS today to discuss more options.

— All rights reserved. For use or reprint in your blog, website, or publication, please contact us at cipromsmarketing@ciproms.com.Photo by GotCredit via Flickr used with permission under the Creative Commons License.

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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