Outpatient Surgery Magazine - Subscribers

Helping Hand - Outpatient Surgery Magazine - July 2019

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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2 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 1 9 A mbulatory surgery center payment rates as a percentage of the hospital outpatient department rates have steadily declined over the years. In 2003, procedures performed in an ASC setting cost Medicare 85% of the amount paid to HOPDs. That figure dropped to 55% in 2014 and today stands at 50%. It's important to note that ASC payments have not declined during this time. What has declined is, on average, the percentage of HOPD payments the ASC payments represent. The No. 1 reason for the widening cost differentials? CMS uses sepa- rate inflationary measures to determine reimbursement rates for HOPDs and ASCs. For years, the Ambulatory Surgery Center Association (ASCA) has been asking Congress and CMS to update ASCs using the same inflation factors they used for HOPDs. And that finally happened this year — one of several recent successes in our efforts to level the reimbursement playing field between ASCs and hospitals. Leveling the Payment Field for Surgery Narrowing the reimbursement disparities between ASCs and HOPDs. Legal Update William Prentice • DIFFERENT INFLATION MEASURES For years, CMS has determined reimbursement rates for hospital outpatient depart- ments and ASCs using 2 different measures of inflation, resulting in significant cost differentials.

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