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Fazio Looks Forward to Working on Medicare Advisory Panel

The ASCA nominee joins seven other new members on the team that advises CMS on outpatient payment systems

BY SAHELY MUKERJI | AUGUST 2023

Brandon Fazio

Brandon Fazio, senior director of financial analysis of Ambulatory Surgery Centers at Community Health Systems in Franklin, Tennessee, says that he is looking forward to his first meeting, August 21–22, as a member of the Advisory Panel on Hospital Outpatient Payment (HOP).

“The secular trend of healthcare moving to the outpatient setting will continue for many years,” Fazio says. “I look forward to participating in the development of regulations that will further drive this trend in a manner that is appropriate for patient safety.”

ASCA nominated Fazio to the panel. The Hospital and Ambulatory Policy Group of the Centers for Medicare & Medicaid Services (CMS) appointed Fazio and seven other new members to serve on the HOP panel recently. This is ASCA’s second successful nomination; former ASCA Board president Terry Bohlke served on the panel from 2019–2023.

The HOP panel advises CMS on the ambulatory payment classification (APC) groupings and weights, which are the basis of the Medicare Hospital Outpatient Prospective Payment System (OPPS) as well as the ASC payment system. The panel also advises on potential changes to the inpatient-only list and other technical issues regarding APCs.

“My background in the ASC industry and detailed understanding of procedure costs and how the APC groupings can impact utilization will, hopefully, add a needed voice in this part of the process,” Fazio says.

The 15-member panel, led by a federal official who serves as chair, helps determine payment policies for both hospital outpatient departments and ASCs. Currently, statute requires all HOP members to be employed by a hospital or health system.

Since CMS tied the ASC payment system to the OPPS approximately 15 years ago, ASCA has worked to give ASCs a seat at the table when policies are contemplated that impact both payment systems. Ensuring that the HOP panel includes at least one representative of the ASC industry has been one such effort, and is currently included in a provision of the Outpatient Surgery Quality and Access Act of 2023. Although ASCA has now successfully nominated two individuals to the panel by working with health systems that also include ASCs, this legislation would open up a position for someone who is not directly affiliated with a hospital or health system.

“ASCs deserve to have a voice on this important panel, and I’m pleased that Brandon will be able to provide the surgery center perspective on payment policies that can lead to better Medicare beneficiary access to cost-effective care,” says Bill Prentice, chief executive officer of ASCA.