MedPAC to Congress: Eliminate ASC pay update for 2022

The Medicare Payment Advisory Commission, an independent congressional agency advising Congress on Medicare-related issues, recommended several changes for ASCs next year in its annual report to Congress, released March 15.

Seven takeaways:

1. MedPAC reported access to capital in the ASC market was adequate because the number of ASCs is up and consolidation is steady. The report also said Medicare accounts for around 20 percent of ASC revenue on average.

2. MedPAC recommended Congress eliminate the Medicare conversion factor update to ASCs in the 2022 calendar year because the number of ASCs and Medicare spend on ASC services is increasing.

3. There were 5,816 Medicare-certified ASCs in 2019, a 2.5 percent year over year increase. For the previous five years, the number of ASCs increased 1.7 percent on average.

4. CMS spent $5.2 billion on ASC services in 2019, which is the most recent data available. Payments increased 8.3 percent per fee-for-service beneficiary that year, up from the average of 5.8 percent growth from 2014-18.

5. MedPAC recommended HHS collect ASC cost data as soon as possible. The agency first recommended collecting ASC cost data in 2010, including total facility costs, Medicare unallowable costs, total Medicare payments and cost data related to employee compensation and medical supplies.

6. Sixty-five percent of ASCs were single specialty in 2019:

· Gastroenterology: 21 percent
· Ophthalmology: 21 percent
· Pain management: 12 percent

7. Thirty-five percent of ASCs are multispecialty, with 4 percent being pain management and orthopedics ASCs. Twenty-five percent of the multispecialty ASCs had more than two specialties.


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