Mr. Herger cited a 2003 OIG report that found Medicare paid $1.1 billion more for services in 1999 because they were provided at hospital outpatient departments rather than in ASCs. “Since that time, payments to ASCs have diverged even further from that of HOPDs ,” he wrote. “While there may be differences in costs related to regulatory requirements and patient population served, it is important to understand that the availability of safe and effective surgical care in the ASC setting and the impact the provision of that care has on aggregate Medicare expenditures.”
He asked that HHS analyze: the impact on aggregate Medicare expenditures; whether differences exist in treatment and quality outcomes for similar services performed in HOPDs versus ASCs; the implications if Medicare payments continue to diverge; the extent to which hospitals are acquiring ASCs and moving services under the hospital’s license to collect higher HOPD payment rates; and potential policy changes that could facilitate Medicare beneficiaries receiving outpatient surgery in the most appropriate setting based on price and quality.
Read the letter from Rep. Herger to David Levinson.
Read more on ASCs and HOPDs:
–The Ambulatory Surgery Center Industry: Evolution and Future
–Management Group’s Role in Physician/Hospital Joint Ventures
–CMS Final Rule Gives ASCs .02% Increase for 2011
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.