Understanding ASHA’s 2025 Payer Summit
The American Speech-Language-Hearing Association (ASHA) recently held its annual Payer Summit on May 15-16, 2025. This gathering brought together key stakeholders, including representatives from private insurance companies, state Medicaid agencies, and Medicaid managed care organizations, to address critical issues facing the audiology and speech-language pathology professions.
Key Issues Discussed
The summit focused on several pressing challenges:
- Decreasing and capitated rates
- Rising paperwork burden
- Coverage limitations
- Third-party administrators
- Anticipated changes to Medicaid and managed care
ASHA staff took the opportunity to discuss coverage, coding, and payment policy issues with payer representatives, advocating for changes that would better support providers and patients alike.
Collaborative Solutions
During the summit, ASHA identified ways to enhance support for audiologists and speech-language pathologists. One significant area of focus was the inclusion of new caregiver training codes in fee schedules. ASHA emphasized the need for payers to understand the financial and logistical burdens placed on providers, advocating for timely access to medically necessary services.
ASHA also educated payers on:
- The importance of covering new caregiver training codes
- Changes to Medicaid and managed care
- Challenges with third-party administrators
- The potential of telehealth and same-day services
- The impact of burdensome prior authorization requirements
Innovations and Opportunities
The summit also served as a platform to discuss future innovations in the payment space. Attendees shared potential advancements, including value-based care and the use of artificial intelligence, to improve the provider and patient experience. The discussions highlighted opportunities for ASHA and attendees to enhance provider training and resources, focusing on:
- Documentation for insurance
- Responding to denials
- Drafting appeals
Looking Ahead
ASHA is committed to developing resources based on the summit discussions and continues to advocate for necessary changes to improve the provider and patient experience. The organization aims to engage with attendees to share guidance, research, and data, supporting advocacy on key issues like limited coverage and reimbursement rates.
The Importance of the Payer Summit
Established in 2019, the Payer Summit is crucial for building relationships between health insurance payers and ASHA staff. It provides a platform for sharing information directly from ASHA members, addressing issues and questions that impact the field. The summit is a result of feedback gathered from member committees, advocacy networks, and individual conversations.
Past summits have led to significant outcomes, such as discussions on problematic prior authorization practices and the adoption of new caregiver training codes. This year’s summit has already sparked interest in continued engagement with ASHA to facilitate meaningful changes.
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