CMS Actuaries Bolster ASC Association’s Argument Against CPI-U

The healthcare reform law contains a provision requiring all Medicare providers’ payment updates, including surgery centers’, to be reduced by a productivity adjustment. Last year, the payment update for ASCs was reduced by 1.1 percent, compared to 1 percent for the hospital market basket.

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Earlier this week, the Office of the Actuary for CMS released its annual report on projected expenditures for the Medicare system. According to a section in the report on the required productivity adjustments:

“Some Medicare payment systems (such as payments for ambulatory surgical centers and laboratory tests) are updated by the CPI, which is already an output price index. These updates will also be reduced by economy-wide multifactor productivity gains under the new law, essentially requiring that these providers and suppliers achieve twice the rate of economy-wide multifactor productivity increases to break even.”

Keith Metz, MD, the chairman of the ASCA’s Government Affairs Committee, responded, “Even CMS’ own actuaries recognize the inherent unfairness in using the CPI-U as an update factor for ASC payments. Not only are ASCs reimbursed 58 cents on the dollar, but now CMS expects our facilities to achieve twice the productivity gains as other Medicare providers.”

ASCA will continue to fight for CMS to change the way ASC payments are updated from the CPI-U to the hospital market basket.

Read the ASCA report on this issue.

Related Articles on Legislation Affecting ASCs:
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Tony Mira: Collecting Payments From Anesthesia and Pain Medicine Patients
Aetna Program Aims to Increase In-Network Referrals

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

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Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

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