4 Findings on ASC vs. HOPD Payments
The study examined payments in knee and shoulder surgeries in 23 states during 2011, which represent two-thirds of workers compensation benefits in the United States. Major findings included:
1. As conventional wisdom suggests, ASCs were less expensive than HOPDs in most states. The only consistent exception was Connecticut.
2. Most states studied employed different algorithms for determining payments for ASCs and HOPDs.
3. ASC network participation rates explained why ASC surgeries were more expensive than HOPD surgeries in some isolated cases.
4. Billing practices, or whether a facility billed for multiple surgical procedures during a single surgical event, also affected relative pricing. ASCs were more likely to bill for multiple procedures from a single surgical event, according to the report.
5. Workers compensation payments were lower at ASCs than in HOPDs in some states because of a lower fee schedule, most evident in Illinois, South Carolina and Texas.
More Articles on Turnarounds:
Frantz EyeCare Celebrates 20 Years
From Follower to Leader: 5 Tips for Success
5 Observations on New ASC Physician Buy-In
© Copyright ASC COMMUNICATIONS 2016. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.
To receive the latest hospital and health system business and legal news and analysis from Becker's Hospital Review, sign-up for the free Becker's Hospital Review E-weekly by clicking here.