July 13, 2016

Price increases much lower in ASCs than hospital outpatient departments

By: Judy Mathias

Many services that once were performed only in hospitals are now being done safely and more conveniently in ambulatory surgery centers (ASCs). Though ASCs now compete with hospital outpatient departments, the difference in overall costs of providing a surgical service in the two types of facilities is not known.

This study from the Boston University School of Public Health examines prices paid to ASCs from 2007 to 2012.

For six common outpatient surgical procedures, prices paid to ASCs grew in line with general medical care, whereas prices paid to hospital outpatient departments for the same procedures increased from 32% to 76%.

Results show a considerable discrepancy between what private insurers and Medicare pay for the same procedure. Medicare pays ASCs a legislated percentage of what it pays hospitals, but there is a large difference between the payment ratio that determines Medicare payments to ASCs and the ratio of payments made by private insurers.

This finding questions the use of a single ratio for ASC payments to hospital outpatient payments, the author says.

—Carey K. Price increases were much lower in ambulatory surgery centers than hospital outpatient departments in 2007-12. Health Aff. 2015;34(10):1738-1744.


Join our community

Learn More
Video Spotlight
Live chat by BoldChat