ASCA Statement on MedPAC Recommendation to Update ASC Payment Rates



WASHINGTON, DC, March 16, 2011 – The Ambulatory Surgery Center Association (ASCA) released the following statement concerning the Medicare Payment Advisory Commission’s (MedPAC) recommendation to Congress regarding a .05 percent payment update for CY2012:

“The modest payment increase notwithstanding, we are pleased to see MedPAC beginning to acknowledge our concerns about the impact that a growing divergence in rates between the ambulatory surgery center and hospital outpatient settings is having on the marketplace.

“MedPAC’s recommendations reflect the vital and growing role that ASCs play in the health care system. As central providers of essential surgical and diagnostic care, including many preventive services, ASCs perform more than 22 million surgeries in over 5,200 facilities throughout the country and are often the most cost‐effective surgical setting both for patients, payors and the health care system.

“In addition, the report recognized the benefits that ASCs offer, stating ‘ASCs can offer [patients] convenience and efficiency relative to hospital outpatient departments (HOPDs)—the sector with the greatest overlap of surgical services with ASCs. For patients, ASCs can offer more convenient locations, shorter waiting times, and easier scheduling relative to HOPDs; for physicians, ASCs may offer more control over their work environment, customized surgical environments, and specialized staff.’

“MedPAC’s report also raised legitimate questions regarding the payment differentiation between identical services provided in different settings, particularly with regard to differences
in payment rates for services administered in ASCs versus HOPDs. For example, ASCs are currently reimbursed by Medicare 43 percent less than HOPDs for the same procedures. The
ASC industry looks forward to working with MedPAC and policymakers as they continue to examine this inequity and establish a stable and reliable Medicare payment structure for ASCs.

“MedPAC also cited the value in having the Centers for Medicare and Medicaid Services (CMS) collect data on ASC quality. ASCA supports providing information on quality measures to
promote industry transparency and encourages CMS to use its authority to collect data in all 50 states so that consumers can make informed decisions about their health care service provider. Since 2006, ASC industry leaders and trade associations with a focus on health care quality and safety regulations have worked together to develop independent quality measures appropriate for ASCs. The National Quality Forum has already endorsed six of these measures and more than 20 percent of the industry is already voluntarily collecting data on the measures.”

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About the Ambulatory Surgery Center Association (ASCA): ASCA is working to raise awareness of the important role that ASCs play in the US health care system and the high-quality, cost-effective care that ASCs provide. For more about ASCA, go to www.ascassociation.org.