Hospital outpatients departments bigger winner than ASCs when more same-day surgeries OK'd

CMS approval of procedures in ASCs often results in large growth in hospital outpatient departments and little or no growth in ASCs, according to an analysis published Jan. 7 by Philips Advisory Board

Optum teamed with the Philips Advisory Board to examine how CMS approval of 27 procedures in ASCs shifted where surgeons performed procedures. 

The analysis looked at the six procedures added to the ASC payable list from 2014 to 2019. For all but one procedure, approval by CMS led to higher surgery volume increases at hospital outpatient departments than at ASCs. The analysis points to limited ASC infrastructure and physician affiliation, among other ASC challenges, as the causes of the disparity.

Here is how surgery volume increased at ASCs compared to hospital outpatient departments for six procedures approved by CMS:

Laparoscopic supracervical hysterectomy:

ASC: 0 percent increase

HOPD: 16 percent increase

Total laparoscopic hysterectomy:

ASC: 1 percent increase

HOPD: 15 percent increase

Cervical spinal fusion:

CMS ASC: 1 percent increase

CMS HOPD: 26 percent increase

Lumbar spinal fusion:

CMS ASC: 0 percent increase

CMS HOPD: 6 percent increase

Vaginal hysterectomy:

CMS ASC: 1 percent increase

CMS HOPD: 11 percent increase

Sacroiliac joint fusion:

CMS ASC: 18 percent increase

CMS HOPD: 13 percent increase

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