The study, in the April issue of Health Affairs, concluded that when surgeons invest in an ASC, they perform twice as many surgeries as non-investing surgeons.
Since owners are apparently motivated by profit, “one potential explanation” for the jump in surgeries is “these physicians may be lowering their thresholds for treating patients with these common outpatient procedures,” the author states.
But the study acknowledged ASCs present “some definite advantages” for surgeons and patients and it stated, “we need to better understand the implications of these new findings.”
The advocacy committee said the study makes “inaccurate statements about the relationship between physician ownership of ASCs and higher surgical volume.”
The committee said the study relied solely on surgical volume as a proxy for ASC ownership. “Volume is not a valid method for identifying which physicians have ownership interests in ASCs,” the committee said. “In fact, many non-owners practice at ASCs.”
The study, conducted by researchers at the University of Michigan, examined Florida patients undergoing five common outpatient procedures: carpal tunnel release, cataract excision, colonoscopy, knee arthroscopy and myringotomy with tympanostomy tube placement.
Identifying physicians who were ASC owners, the study compared their volume of surgeries before and after they became owners and also compared that volume with that of physicians who remained non-owners.
Two of the findings were:
- Owners operated on twice as many patients as non-owners.
- Owners’ surgical caseloads increased more rapidly and dramatically from earlier to later time periods than caseloads of non-owners.
The ASC advocacy committee pointed to a previous study finding that most of the growth in ASC volume was due to migration of surgeons from hospitals to ASCs, not new surgical cases. Indeed, this 2009 study by KNG Health Consulting found that 94 percent of ASC volume in ophthalmological cases came directly from hospitals.
In a separate note to ASC owners, the advocacy committee said it “will work vigorously to correct the misinformation reported in the press and offer insight and expertise for reporters planning to cover this research.”
Read the ASC Advocacy Committee’s response to the study.
