Health Care Stewardship: Surgery centers, medical travel can mean fair prices for members

Every day at Samaritan Ministries, the Provider Relations team works heartily unto the Lord for our members. They steward member Share dollars by pursuing fair prices for medical bills that members submit.

One way the team does this is through direct negotiation of medical bills with the provider. To do this most effectively, the Provider Relations team has developed relationships directly with providers to gain their trust. They also share strategies with members on how to choose providers that are high quality and have fair prices.

One target area in achieving greater success in getting quality service at a fair price is increased member use of ambulatory surgery centers (ASCs).

ASCs are care sites that offer surgical procedures, diagnostics, and preventive care services, according to the Ambulatory Surgery Center Association. These sites are different than provider offices, rural health care clinics, urgent care facilities, or ambulatory care centers.

A quick online search found more than 8,000 ambulatory surgery centers in the U.S., most of which can be found through Healthcare Bluebook™, which is accessed through the Samaritan Dashboard’s Health Resources.

How they save

Why is ASC usage a key focus in our effort to contain member costs?

• Over the past year, the average cost of an ASC procedure through our travel program has been $8,674. This is a savings of $21,141 off the estimated hospital outpatient price.
• The price difference represents an opportunity to reduce costs of a procedure by an average of 71 percent.

What you can do

Here’s what you as a member can do to help:

• Actively pursue using ASCs in your area. Be aware that many surgeons perform procedures at multiple facilities, and the price at an ASC is often substantially lower than when performed in a hospital.
• Look for ASCs that provide upfront, all-inclusive pricing. These bundled prices include physician/surgeon, anesthesiology, facility, and miscellaneous fees.

Travel program

In addition, if you cannot locate a provider in your area that meets these criteria, Samaritan Ministries’ Care Compass program can help you find care outside your area.

Care Compass provides:

• $1,000 Share credit possible for using Care Compass-eligible ASCs.
• $300 per diem (approved travel and procedure days)

Currently there are 48 eligible ASCs for this program, with more to be added in the future. These spread from Willow Grove, Pennsylvania, to Spokane, Washington. They are as far north as Ponderay, Idaho, and south as Harlingen, Texas. If those 48 prove too far to travel, there are options that increase flexibility.

Here’s how Care Compass works:

Start your need online or by speaking with a Needs Advocate.

• Contact the Provider Relations team by being transferred after starting your need, sending an email to [email protected], or by calling them at (877) 764-2426, Ext. 7082.
• Provide information about your condition and whether you know what the required treatment may be. If you already have an estimate, please provide it. If not, please contact our Provider Relations department anyway.
• Once you provide this information, it will be reviewed by our Provider Relations team so they can discuss possible options and next steps with you.

Once the surgery is completed, you have submitted the bill, and you have notified our Provider Relations team of completed care via phone or email, Samaritan Ministries will add the credit to your membership, your approved travel will be shared, and the fair price reward waiving your Initial Unshareable Amount will be applied.

Kansas family saved big

A Samaritan member family in Kansas was able to take advantage of both types of services.

Jadyn needed ankle surgery in 2023. The family’s provider at the time was charging $33,791 just for the facility and asking for half to be paid upfront.

After receiving information from Samaritan, however, the family switched to Surgery Center of Oklahoma, which has high quality ratings. Also, the members had family members in the state.

The total bundled cost for the surgery—including facility, physician, and anesthesia—was $8,573 This cost reduced the amount they had to pay upfront in half as well and ended up saving Samaritan members more than $20,000.

Jadyn’s mother, Jeri, said the experience at Surgery Center of Oklahoma was very good. She also noted a “cool God thing” happened when the surgeon who performed the procedure turned out to be a good family friend and had performed surgeries on other family members before.

Keep options in mind

ASCs are high-quality alternatives to hospital outpatient procedures, save substantial amounts of money, and often reduce billing paperwork.

The next time you have a need for this type of medical procedure, please strongly consider your ASC options and Care Compass.