Commercial insurers paid far less for common gastrointestinal procedures performed in ASCs than in hospital outpatient departments, a recent study found.
Insurers paid an average of $1,042 (110%) more when a surgery occurred at an in-network HOPD compared to those performed at an in-network ASC. Out-of-network ASCs were also more expensive, costing insurers $306 (32%) more than in-network ASCs, according to a study published Oct. 6 in the American Journal of Managed Care.
For patients, out-of-pocket costs followed a similar pattern, with those receiving care at in-network ASCs paying the least. On average, a GI procedure at an in-network HOPD cost patients $186 more out of pocket than at an in-network ASC. Out-of-network procedures were significantly pricier regardless of setting.
Researchers concluded that both patients and insurers save money when GI procedures are performed at in-network ASCs, suggesting that insurance models that align with these incentives could lower overall outpatient surgery spending.
