CMS ups inpatient rates 4.3% for 2023; what should ASCs expect?

CMS plans to boost acute care hospital pay 4.3 percent next year, as long as the hospitals comply with quality data reporting.

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The rate hike for inpatient pay is the highest market basket update in 25 years, which CMS attributed to “higher than expected growth in compensation prices for hospital workers.” The final rule is a shift from earlier this year, when CMS pitched a rate cut.

Can ASCs expect a similar boost?

CMS proposed increasing ASC pay rates next year by 2.7 percent in July, which does not keep up with the current 9.1 percent inflation rate. Like hospitals, ASCs have had to boost staff wages to stay competitive and reported an increase in supply costs this year. CMS is accepting comments on the proposed payments through Sept. 13 and will issue the final rule in November.

It is unknown how CMS is leaning, but the agency’s policy updates during the Biden administration have not necessarily favored ASCs. Last year, CMS removed procedures from the ASC payable list that had been transitioned there during the Trump administration, and then this year it pitched adding one only more procedure to the ASC payable list.

Bill Prentice, CEO of the Ambulatory Surgery Center Association, said the agency provided clinical data to CMS showing that more procedures were safe and effective in the ASC setting.

“This proposed rule misses an opportunity to lower costs and improve access to care to beneficiaries by not adding many viable procedures that ASCs are safely performing on commercial patients,” he said in a July 15 press release.

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.

Register to Attend Webinar

160 ambulatory leaders just ranked the EHR as the single system most overdue for AI reinvention

Tuesday, August 11
12:00 PM - 1:00 PM CDT

Presenter: Gautam Shah, MBA, FACHDM, NextGen Healthcare

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