ASC Reimbursement Trends as a Percentage of HOPD

Ambulatory surgery center reimbursement as a percentage of hospital outpatient departments has declined steadily since 2003, with a huge drop between 2003 and 2008, according to the VMG Multi-Specialty ASC Intellimarker 2011 report.

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In 2003, ASCs were reimbursed 87 percent of what an HOPD would receive. By 2008, they were only reimbursed at 63 percent on average. Over the next three years, the decline continued:

2009: 59 percent
2010: 58 percent
2011: 56 percent

CMS released its Medicare 2013 final rule to include a 0.6 percent rate increase for ASCs. This was down from a proposed 1.3 percent update in the proposed final rule. The increase is based on a 1.4 percent projected rate of inflation and a 0.8 percent point decrease for productivity adjustment required by the Patient Protection and Affordable Care Act.

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