ASCA: Pennsylvania Report Undervalues State Surgery Centers
The Ambulatory Surgery Center Association released the following statement today regarding a recent report form the Pennsylvania Health Care Cost Containment Council:
"The findings of the PHC4 report and several other factors must be considered carefully in order to obtain an accurate understanding of the true value that Pennsylvania ambulatory surgery centers provide. ASCs continue to gain popularity among patients because they provide top-quality care at substantially less cost than hospital outpatient departments. With healthcare costs increasing every year, ASCs represent a substantial value and a model of success."
"The PHC4 report acknowledges that ASC and hospital profit margin rates available from the state cannot be compared directly because of the difference methods used to calculate those statistics. For example, the disbursement (or salaries) that are paid to the physician-owners of ASCs are not counted as overhead. This would be similar to removing all physician compensation from the operating costs of the hospitals before calculating their margins, which would increase significantly using that methodology. Also, the total margin for most for-profit ASCs does not reflect income tax expenses. By comparison, total margins for Pennsylvania's for-profit general acute care hospitals are calculated after the tax expense is deducted."
"ASCs are — by design — convenient, personalized, lower-priced alternatives to hospitals for certain procedures. Built-in efficiencies reduce overhead and waste. For example, ASCs allow better control over scheduling, so procedures are not delayed or rescheduled due to staffing issues or competing demands for operating rooms pace from emergency cases."
ASCA asked readers to also consider the following points:
• On average, Medicare reimburses ASCs only 58 percent of the rate it pays hospitals for providing similar procedures. This payment system saves Medicare $2.6 billion a year and patients even more due to reduced co-pays.
• Due in part to this cost differential, one-third of ASCs that have left the Medicare in the last 2.5 years have been bought by a hospital and converted to a HOPD, including three in Pennsylvania. This can lead to significantly increased costs for payors.
• ASCs are small businesses that provide jobs to the local community and pay state and federal taxes.
• Two-thirds of nationwide ASCs provide free or reduced-cost care for patients. They do not receive financial incentives for providing that care.
Related Articles on Coding, Billing and Collections:
MaineCare to Stop Reimbursing for Ambulatory Surgery Center Services
How to Successfully Handle Out-of-Network Contracts in ASCs
5 Tactics to Negotiate Bundled Payments for Surgery Centers
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