How Medicare is stifling ASC migration

CMS policies are stifling the migration of procedures to the outpatient setting, Bill Prentice, CEO of the Ambulatory Surgery Center Association, said at a California Ambulatory Surgery Association summit with payers and industry stakeholders. 

Here are three points on the obstacles of outpatient migration discussed at the event, according to an email shared with Becker's. 

1. Many organizations, including ASCA, are working to convey the cost-saving opportunities in ASCs to Congress. By not letting ASC rates fall too far behind those of hospital outpatient departments, Medicare can save a significant amount of money, Mr. Prentice said. 

2. Medicare currently caps copays for Medicare beneficiaries receiving procedures at a hospital, but does not cap the copay at ASCs. This creates an incentive for the patient to go to the hospital outpatient department, according to Mr. Prentice, despite the lower cost opportunities at ASCs.

3. "We need to be aligned, and have specialist societies advocating to CMS to move more procedures to ASCs, and to get the physician and nursing communities to become more engaged in ASC advocacy as well," Mr. Prentice said, according to the email. 

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