In the proposed rule, CMS is implementing the final transition for ASCs from the grouper system to the revised ASC payment system based on the relative weights used in the Outpatient Prospective Payment System.
The ASCAC is concerned that payment updates for ASCs will remain based on the Consumer Price Index for all Urban Consumers (CPI-U), despite recommendations that updates to ASC payment be based upon the hospital market basket, which is employed to update hospital inpatient and outpatient payments.
Over the last seven years, the relationship between ASC and HOPD payments fell from 86 to 58 percent for identical services. Under the 2011 proposed rule, ASC rates will drop below 56 percent of the hospital rate for the identical service, and it is anticipated that the gap will grow further going forward.
MedPAC has acknowledged that the CPI-U is an inaccurate mechanism for updating ASC payments, and, in June, 32 members of the House of Representatives wrote to CMS pushing for use of the hospital market basket for ASCs, the only healthcare facility to have its payment based on the CPI-U.
“Aligning the indexes across ASCs and HOPDs would provide a positive update for ASC payments consistent with MedPAC’s recommendation and ensure that ASCs have the resources needed to implement new technology, enhanced reporting systems, and the ability to continue providing high quality, patient-centered care,” said Andrew Hayek, chair of the ASCAC and president and CEO of Surgical Care Affiliates, according to the release.
Read the news release about ASCAC’s concerns about the 2011 CMS proposed rule.
Read more about the ASC proposed rule:
