The Medicare Payment Advisory Commission has released its 2015 Ambulatory Surgical Center Services report. Here are nine things to know about the report and MedPAC’s recommendations.
1. MedPAC recommends that Congress should eliminate payment updates for ASCs in 2016. MedPAC also recommends that ASCs be required to submit cost data.
2. In 2013, 5,364 ASCs provided care to 3.4 million fee-for-service Medicare beneficiaries. The Medicare program and beneficiaries spend $3.7 billion on ASC services.
3. This year, Medicare rates for hospital outpatient departments are 82 percent higher than ASC rates.
4. MedPAC concluded that 2015 payments to ASCs are adequate and Medicare beneficiaries have adequate access to care in ASCs. The organization also noted that Medicare payments to ASCs have steadily grown.
5. The growth rates of ASCs slowed from 4.2 percent in 2008 to 1.1 percent in 2013.
6. MedPAC noted that outpatient volume is growing at a faster rate in HOPDs than in ASCs. From 2012 to 2013, volume per fee-for-service beneficiary increased 0.5 percent in ASCs, but rose 3.1 percent in HOPDs.
7. MedPAC reported Medicare beneficiary access to ASCs should be maintained due to disparity in spending between ASCs and HOPDs.
8. The organization urges Congress to implement a value-based purchasing program for ASCs no later than 2016. Recommended measures to include in the program: patient falls, patient burns, wrong site surgery, hospital transfer and surgical site infections.
9. MedPAC suggests revisiting the consumer price index for all urban consumers as the market basket to update ASC payments, as the CPI-U may not reflect ASC cost structure.