20 key findings from MedPAC's report on ASCs in 2019

Here are 20 core aspects of MedPAC's 2019 report on ASCs.

1. Two key recommendations to Congress:

• No increase or update to the conversion factor for ASCs in 2020.
• ASCs should have to submit cost data. This is aimed at getting at the profits from ASCs and is intended to lower the payments made to ASCs long term.

2. Medicare and beneficiaries spent about $4.6 billion on ASCs in 2017 for patient care.

3. The number of ASCs grew by 1.1 percent from 2012 to 2016 and 2.4 percent in 2017.

4. While 189 ASCs opened in 2017, 60-plus closed.

5. There are now 5,603 Medicare-certified ASCs; 114 closed in 2012 and 90 in 2016.

6. Around 40 percent of ASCs are multispecialty, and 30 percent of those have more than two specialties.

7. For Medicare, ophthalmic and GI procedures are the most performed procedures.

8. The top 20 procedures represent 71.1 percent of ASC procedures.

9. Surgical volume grew faster in ASCs than HOPDs, reversing a several years-long trend. ASC volume was up 1.7 percent in ASCs and 0.7 percent in HOPDs for 2017.

10. The average ASC has three operating rooms.

11. About 94 percent of ASCs are for-profit facilities.

12. Around 94 percent of ASCs are urban and 6 percent are rural.

13. Safety is improving in ASCs.

14. In MedPAC's view, there is an adequate supply of ASCs.

15. Most Medicare-certified ASCs are single specialty, primarily GI, ophthalmic and pain centers. MedPAC expressed some skepticism towards pain management in ASCs.

16. There were about 100 more pain centers in 2017 than 2015.

17. Spinal neurostimulator volume at ASCs jumped from 2,000 in 2012 to 9,500 in 2017.

18. ASCs are paid about 50 percent of what hospital outpatient departments are paid for the same service. For example, in 2019 a cataract in an HOPD is reimbursed at $1,917 while a cataract in an ASC is reimbursed at $977.

19. More high-cost procedures and spinal neurostimulator implantations in the ASC drove annual spending per Medicare beneficiary growth of 7.7 percent in 2017.

20. Maryland had the highest number of ASCs per Medicare beneficiary in 2017, followed by Georgia, Alaska and Wyoming.

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