ASC Policy Focus
Ambulatory Surgery Centers (ASCs) are an integral part of the health care system, providing critical access to essential surgical and diagnostic care, including preventive services. More than 22 million surgeries and procedures, including many orthopedic, eye, and abdominal surgeries, are performed annually in more than 5,200 ASCs in the United States. ASCs are often small community businesses run by licensed medical professionals with specialized expertise, and ASCs offer convenient access and scheduling for patients.
ASCs are often the most cost-effective surgical setting both for patients, payors and the health care system. Compared to the hospital outpatient setting, every procedure performed in an ASC saves the Medicare program more than 40 percent and saves Medicare beneficiaries more than 50 percent on their co-payments. In fact, shifting just half of all eligible outpatient procedures from hospital outpatient departments (HOPD) to ASCs would save Medicare an additional $2.3 billion.
To ensure that ASCs are able to continue to provide high-quality, cost-efficient, patient-centered care, it is important that policymakers establish a stable and reliable Medicare payment structure for ASCs. Despite ASCs’ role in creating savings for the health care system, Congress prohibited the Medicare program from increasing ASC payment rates for six years. As a result, the relationship between ASC and HOPD payments fell from 86 to 58 percent for identical services since 2003. The 1.2 percent update in 2010 did not narrow the gap between the ASC and hospital payments. The increasing separation between rates will jeopardize facilities’ ability to recruit and retain a skilled workforce, keep pace with technological advancements, implement electronic health records, and comply with increasingly complex regulations.
ASCs offer the government and patients meaningful health care savings opportunities, yet continued pressure on ASC payments could shift care to return to more expensive surgical settings. We believe that the best policy for Medicare is to continue the migration of appropriate surgical cases into ASCs, which has been occurring for the past 40 years as anesthesia and surgical technology has improved. Fostering continued involvement of ASCs in the Medicare program will benefit patient care and create significant cost savings for patients and the health care system overall.
Additionally, ASCs support the collection of clinical outcomes data to provide patients with a wide range of information on their surgical care options. ASCs also support government initiatives to gather additional industry metrics – such as quality, safety and patient satisfaction data – and study the important role that ASCs play in improving our healthcare system and providing access to important surgical and preventive services. We encourage the Medicare program to present quality metrics to the public in a way that helps consumers make informed choices about their surgical care options. ASCs are proud of their outstanding care, service and clinical outcomes.
ASCs are committed to working with policymakers to improve our healthcare system and to ensure that Americans continue to receive the high-quality and patient-centered care from facilities across the country.
Learn about issues that are important to ASCs.
Dowload the ASC letter to CMS in response to proposed changes to their Conditions for Coverage.
Download the ASC Congressional testimony to the House Energy and Commerce Subcommittee on Health.
Download and Read about the 7 Important Issues Affecting ASCs in the CMS Proposed Payment Rule.
Download the Letter to Secretary Sebelius on Value-based Purchasing.
Download the bipartisan Senate letter to CMS urging the agency to update the ASC payment system.
