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Ambulatory Surgery Centers 'Pivotal' in Moving Outpatient Surgical Services Into Less Expensive, Clinically Appropriate Settings
Date:6/16/2009

of the relatively low Medicare payment rates for ASCs.

First, some ASC critics have suggested that physicians who own ASCs have a financial incentive to perform more surgical services than they would if they could only provide outpatient surgical services in a HOPD. It has also been suggested that the expansion of outpatient surgical capacity in ASCs may lead to a higher overall volume of outpatient surgery.

This study found no statistical evidence that ASCs cause an increase in utilization of common Medicare procedures like colonoscopies and cataract surgery.

In fact it shows that 70% of the growth in ambulatory surgery centers from 2000 to 2007 is the result of moving procedures from HOPDs into the less expensive ASC setting.

One exception to the migration trend is pain management services. The study noted that significant changes in insurance coverage and advancement in the pain management clinical treatments have evolved in the past 5 to 7 years. Taking these evolutionary events into context, the growth rate for pain management procedures in ASCs is consistent with the growth rate for pain management procedures across all other modalities.

The report also finds that:

  • Growth in factors completely external to the ASC industry, such as the number of Medicare beneficiaries and disease prevalence help explain the total trend and demonstrate the role of ASCs in meeting demographic challenges for Medicare.
  • An increase in the number of necessary and appropriate services per beneficiary is the primary element of spending growth. Most of this growth (70%) is explained by migration of services from the HOPD to the ASC. The remaining 30% is a function of population growth, increased prevention, expanded insurance coverage, and new technologies.
  • Much of the growth in ASC spending has been i
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SOURCE ASC Association
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