Anthem: Shifting certain GI procedures to ASCs could create $12B in savings

Colonoscopies and upper gastrointestinal procedures cost an average of 1.7 times more in a hospital outpatient department than they cost in an ASC, according to a July report from Anthem’s Public Policy Institute.

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The report analyzed claims data from 3.7 million individuals enrolled in Anthem’s affiliated commercial health plans in 14 states.

Three key takeaways:

1. The U.S. healthcare system could realize about $12 billion in savings if 1 in 5 upper GI and colonoscopy procedures shift from HOPDs to ASCs.

2. In 2019, 52 percent of upper GI and colonoscopy procedures were done in an ASC, compared to 48 percent in an HOPD.

3. In 2019, 79 percent of upper GI and colonoscopy procedures done in HOPDs were in counties where an ASC was a viable alternative.

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