UC Berkeley’s Professor Brent Fulton, PhD, and Sue Kim, MD, analyzed government data to determine how much money ASCs saved Medicare in recent years and forecasted future Medicare savings from ASCs.
Here are six key findings:
1. From 2008 to 2011, the federal Medicare program realized $6 billion in savings from ASCs. Medicare beneficiaries saved the other $1.5 billion. ASCs saved Medicare and its beneficiaries $2.3 billion in 2011 alone.
2. ASCs could save Medicare and its beneficiaries as much as $57.6 billion more over the next 10 years.
3. The widening gap in ASC and HOPD reimbursement rates — a result of consumer prices determining ASC rates inflating more slowly than the hospital market basket costs that determine HOPD rates — could jeopardize the savings.
4. If the trend continues, ASC owners will face pressure to leave the Medicare system and be acquired by hospitals. The Medicare reimbursement rate spikes about 75 percent when a hospital acquires an ASC.
5. More than 60 ASCs have stopped participating in Medicare over the last three years because of the disparity.
6. The findings suggest policies that reduce the reimbursement gap and encourage the migration of cases from the hospital setting into ASCs will increase savings for the Medicare program and its beneficiaries.
More articles on coding, billing and collections:
3 biggest ASC fraud cases in 2018
Value-based care progress is grinding to a halt — 5 study insights from Quest Diagnostics
10 things to know about ASC coding audits
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.