States take aim at outpatient facility fees driving higher commercial health costs
Editor's Note States are sharpening their focus on outpatient facility fees, using new data and reporting mandates to expose how these charges inflate commercial healthcare spending, HealthAffairs October 6 reports. Specifically, Colorado, Maine, Connecticut, and Washington have launched varied but increasingly sophisticated efforts to monitor when and where hospitals bill…
Study: Outpatient surgery costs hinge on site of care, network status
Editor's Note Patients and insurers pay far less for outpatient surgical procedures performed at in-network ambulatory surgery centers (ASCs) than at hospital outpatient departments (HOPDs), the American Journal of Managed Care October 6 reports. This study, led by Xiaoxi Zhao, PhD, Christopher Whaley, PhD, and colleagues, analyzed commercial claims data…
Sports medicine procedures cost far less in ASCs than HOPDs
Editor's Note Sports medicine surgical procedures for Medicare patients cost significantly less in ambulatory surgery centers (ASCs) compared with hospital outpatient departments (HOPDs), according to a study published by the Orthopaedic Journal of Sports Medicine on August 29. Researchers analyzed Medicare Procedure Price Lookup data for 62 commonly billed outpatient…
Hospital-affiliated doctors drive highest costs by avoiding lower-cost sites
Editor's Note Patients treated by hospital-affiliated physicians are far less likely to receive specialty procedures in lower-cost settings, while private-equity–affiliated doctors are the most likely to steer patients toward these options, Ambulatory Surgery Center News August 12 reports. The findings come from a Mount Sinai study that examined physician affiliation,…
Translating MIPS Value Pathways into perioperative practice—What OR leaders need to know
In July 2025, the Centers for Medicare & Medicaid Services (CMS) proposed sweeping changes to the Medicare Physician Fee Schedule for calendar year 2026. Among the most impactful updates is the launch of the Ambulatory Specialty Model (ASM)—a mandatory value-based payment program focused on heart failure and low back pain.…
Study: Physician organizational affiliation impacts procedure locations, costs
Editor's Note Hospital-employed physicians are least likely and private equity (PE)-affiliated physicians most likely to provide care in lower-cost ambulatory surgery centers (ASCs) or offices, according to a study published July 24 in the Journal of Market Access & Health Policy These care site differences translate to substantial variation in…
ASCA 2025: Leading lawmaker reflects on surgery center priorities
Editor's Note At the 2025 Ambulatory Surgery Center Association (ASCA) conference, discussion of legislative priorities extended beyond educational sessions. Thanks to a visit from the ranking lawmaker of the congressional subcommittee responsible for most healthcare policymaking, attendees also got first-hand insight into the latest negotiations on Capitol Hill. US Representative…
US News & World Report releases results of second annual ‘Best ASCs’ ratings
Editor’s Note US News & World Report announced on March 18 its 2025 Best Ambulatory Surgery Centers (ASCs) ratings after evaluating 4,357 ASCs across four key specialty areas—Colonoscopy & Endoscopy, Ophthalmology, Orthopedics & Spine, and Urology. This marks the second annual edition of the publication’s effort to help consumers make…
United Surgical Partners agrees to $1.48M settlement in 401(k) fee lawsuit
Editor's Note United Surgical Partners International Inc. has agreed to pay $1.48 million to settle a proposed class action alleging its 401(k) plan charged excessive fees and included costly investment options, according to a motion filed in Texas federal court, Law360 January 6 reports. The settlement resolves a lawsuit brought…
Hospitals, health groups criticize CMS pay proposals
Editor's Note Hospital groups are criticizing CMS' proposed 2.6% pay increase for 2025, deeming it insufficient for nonprofit hospitals with operating margins near or below zero, according to a July 11 article in Becker’s Hospital CFO Report. The American Hospital Association and America's Essential Hospitals argue the rise won't cover…
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- Telehealth in limbo: Providers split on continuing Medicare services during shutdown
- States take aim at outpatient facility fees driving higher commercial health costs
- Slower acquisitions, mounting debt reshape Surgery Partners growth outlook
- ASCs surge as hospitals and investors chase outpatient growth
- Nearly half of US physicians now work for large systems: GAO links consolidation to higher costs