Tag: HOPD

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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Providers call for deeper reform despite CMS proposing payment hikes in 2026

Editor's Note CMS is boosting 2026 Medicare outpatient payments by 2.4%, but provider groups warn the increase barely scratches the surface of mounting financial strain. Alongside the payment bump, the agency is proposing a two-track physician reimbursement model that ties rates to value-based care participation. While some see these moves…

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By: Tarsilla Moura
July 23, 2025
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CMS 2026 proposed rule: Expanded ASC access, higher payments, tighter quality reporting

Centers for Medicare & Medicaid Services

Editor's Note The Centers for Medicare & Medicaid Services (CMS) just proposed sweeping changes to the Medicare Shared Savings Program and Physician Fee Schedule for calendar year 2026, including extensive changes to outpatient Medicare policy such as payment increases, expanded procedural access, and new quality reporting updates, as outlined in…

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By: Tarsilla Moura
July 16, 2025
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ASC adaptability depends on properly structured leadership

Takeaways • Different types of ASC leadership structures can be adapted to meet organizational needs. • Regulations, accreditation standards, size, and ownership types are examples of factors influencing the leadership structure. • Ongoing success of the ASC leadership team depends on factors such as governing body diversity and strategic planning.…

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By: Cynthia Saver, MS, RN
July 1, 2025
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ASCs deliver lower costs but face uphill payment, regulatory challenges

Editor's Note Ambulatory surgery centers (ASCs) continue to offer significant cost savings over hospital outpatient departments (HOPDs), but payment inequities, regulatory constraints, and growing competitive pressures are straining operations and growth prospects. Recent data show wide cost differentials between settings, Becker’s ASC Review June 20 reports. A Blue Health Intelligence…

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By: Tarsilla Moura
June 25, 2025
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