The Medicare Payment Advisory Commission released its annual report to Congress March 12, which revealed key data points about the sustained growth of the ASC industry and the U.S’s overall healthcare spending.
Here are 15 takeaways from the report:
1. National health care spending totaled $5.3 trillion in 2024, representing 18% of GDP — up from 13% of GDP in 2000.
2. Medicare spending totaled $1.1 trillion in 2024 — 21% of national health care spending and 3.8% of GDP.
3. Medicare spending grew by 9% in 2023 and 8% in 2024, faster than national health care spending, partly due to IRA changes shifting Part D costs from beneficiaries to the federal government.
4. Medicare enrollment reached 67 million in 2024, projected to hit 75 million by 2029.
5. In 2024, about 6,400 ASCs treated 3.4 million FFS Medicare beneficiaries. Total FFS Medicare program spending and beneficiary cost sharing on ASC services was about $7.5 billion.
6. The number of ASCs nationwide grew over 2% per year on average between 2019 and 2024.
7. The volume of ASC surgical procedures per FFS beneficiary increased 3.5% in 2024, after growing at an average annual rate of 1.3% from 2019–2023.
8. Medicare spending per FFS beneficiary on ASC services rose at an average annual rate of 9.4% from 2019 through 2023, and then by a striking 15.9% from 2023 to 2024.
9. Over 95% of ASCs are for-profit, and 94% are located in urban areas.
10. The concentration of ASCs varies widely by state, ranging from more than 36 ASCs per 100,000 Part B beneficiaries in Maryland to 3 or fewer in DC, West Virginia, and Vermont.
11. About 68% of ASCs that billed FFS Medicare in 2024 specialized in a single clinical area. Gastroenterology and ophthalmology were the most common single-specialty types. Among multispecialty facilities, pain management and orthopedics were most common.
12. From 2023 to 2024, the fastest-growing ASC specialties were pain management and cardiology.
13. The most common FFS Medicare procedure in ASCs in 2024 was extracapsular cataract removal with intraocular lens insertion, accounting for 18% of FFS Medicare volume. The top 20 procedures made up about 68% of all ASC FFS Medicare volume.
14. Relative to hospital outpatient departments (HOPDs), ASCs are less likely to treat FFS beneficiaries who are disabled, have Medicaid coverage, or are age 85 or older.
15. In its recommendations, MedPAC also encouraged CMS to synchronize measures in the ASC Quality Reporting Program with the Hospital Outpatient Quality Reporting Program to allow meaningful comparisons between ASCs and HOPDs.
