ASCs vs. HOPDs: 3 cost comparisons

ASCs and HOPDs are vying for similar patient populations, but having procedures done at ASCs versus the latter can yield financial benefits, according to an analysis by the Blue Cross Blue Shield Association. 

Blue Health Intelligence — BCBS' data analytics company — analyzed national claims data for treatment services of 123 million BCBS members at different care sites from 2017 to 2022. The analysis found that costs for health services were "substantially higher" when performed in HOPDs — leading to a higher cost for consumers.

Here are three more of the report's findings:

1. Prices of common procedures were "substantially" higher when performed at HOPDs — some five times more expensive — compared to when performed in an ASC or physician's office setting.

2. Not only were the costs of procedures at HOPDs higher, but the average cost of procedures at HOPDs has increased more over time compared to that of ASCs — increasing by 27% in the last five years compared to 11% at ASCs.

3. HOPDs saw a 27% increase in services performed from 2017 to 2022, while their average increase in price was 27%. At the same time, ASC service volume increased by 34%, while prices in that setting increased by only 11%. 

The report concluded that site-neutral payments — billing the same amount for the same service across care delivery settings — would lead to savings of $471 billion for patients, businesses and employees over the next 10 years.

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