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ASC Reimbursement Trends as a Percentage of HOPD

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Ambulatory surgery center reimbursement as a percentage of hospital outpatient departments has declined steadily since 2003, with a huge drop between 2003 and 2008, according to the VMG Multi-Specialty ASC Intellimarker 2011 report.

In 2003, ASCs were reimbursed 87 percent of what an HOPD would receive. By 2008, they were only reimbursed at 63 percent on average. Over the next three years, the decline continued:

2009: 59 percent
2010: 58 percent
2011: 56 percent

CMS released its Medicare 2013 final rule to include a 0.6 percent rate increase for ASCs. This was down from a proposed 1.3 percent update in the proposed final rule. The increase is based on a 1.4 percent projected rate of inflation and a 0.8 percent point decrease for productivity adjustment required by the Patient Protection and Affordable Care Act.

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