Tag: HOPD

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…

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By: Tarsilla Moura
October 15, 2025
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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…

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By: Tarsilla Moura
October 8, 2025
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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…

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By: Tarsilla Moura
October 1, 2025
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CMS proposal to end inpatient only list draws strong industry response

Editor's Note The plan to eliminate the Medicare Inpatient-Only (IPO) List and expand the Ambulatory Surgery Center Covered Procedures List (ASC-CPL) from the Centers for Medicare & Medicaid Services (CMS) has generated widespread reaction, with more than 3,900 comments submitted during the official feedback period, Ambulatory Surgery Center News September…

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By: Tarsilla Moura
September 22, 2025
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AHA study: HOPD Medicare patients are poorer, sicker, more rural than those seen in physician offices

Editor's Note Medicare patients treated in hospital outpatient departments (HOPDs) present with greater socioeconomic and clinical complexity than peers seen in independent physician offices, including higher prior emergency department (ED) visits and inpatient use. According to an American Hospital Association (AHA) study conducted by KNG Health Consulting and published on…

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By: Tarsilla Moura
September 4, 2025
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August poll results: Service line shifts push ASCs to expand capacity, redefine readiness

The migration of surgical cases from inpatient settings to ambulatory surgery centers (ASCs) continues to reshape perioperative leadership in 2025. Nationally, the trend is driven by payer incentives, patient preference, and cost pressures, with ASCs now performing more orthopedic, spine, and complex outpatient procedures than ever before. In fact, the…

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By: Tarsilla Moura
September 3, 2025
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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,…

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By: Tarsilla Moura
August 20, 2025
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Mind the gap: Why Medicare pays ASCs less than HOPDs—and what that means

For decades, ambulatory surgery centers (ASCs) have shown their ability to deliver high-quality surgical care at substantially lower cost than hospital outpatient departments (HOPDs). ASCs achieve these savings through leaner operations, streamlined staffing models, and specialty-focused efficiencies, not by compromising safety or outcomes. Studies consistently highlight procedures performed in ASCs…

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By: Tarsilla Moura
August 19, 2025
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5 reasons why ASC leaders deserve to be at the 2025 OR Manager Conference

Running an ambulatory surgery center (ASC) is not for the faint of heart. ASC leaders are navigating tight margins, stricter-than-ever quality reporting, lean staffing resources, payer squeeze, and a relentless push to be profitable without proper support. And yet, the ASC market is booming. The number of Medicare-certified ASCs has…

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By: Tarsilla Moura
August 5, 2025
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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…

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By: Matt Danford
July 30, 2025
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