Outpatient Surgery Magazine

Is Your Turnover Team Fast Enough? - August 2014 - Subscribe to Outpatient Surgery Magazine

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

Issue link: http://magazine.outpatientsurgery.net/i/362207

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Page 32 of 124

3 3 A U G U S T 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E Kara Newbury CODING & BILLING Mixed Reviews for 2015 ASC Payment Rule Payment disparities persist, but ASCs could gain ground in other areas. M edicare's proposed 2015 payment rule for ASCs contains a mix of good and bad news for surgery center owners and managers. On the plus side, the ASC payment proposal accommodates some important requests made by the ambulatory sur- gery center community, including the addition of 10 new spine proce- dures to the ASC list of payable procedures and more favorable terms for device-intensive procedures. On the negative side, the disparity in payments between hospital outpatient departments (HOPDs) and ASCs continues to grow under the proposal. Here's a rundown of the important points you need to know. Payment update. CMS is proposing an effective payment update of 1.2% for ASCs and an effective payment update of 2.1% for HOPDs. The disparity is due in large part to the dif- ferent update factors used for each site of service. Facility fees for HOPDs are updated annually, based on the hospital market basket, which measures the inflation of medical costs such as equipment, sup- plies and staffing. ASC facility fees, on the other hand, are updated based on the Consumer Price Index for all Urban Consumers (CPI-U), which measures the cost of consumer goods such as bread, milk and gasoline. The CPI-U is unrelated to changes in medical costs and is historically lower than the hospital market basket. The result is that under the proposal, the rates paid to ASCs and HOPDs will continue the troubling trend of diverging in 2015. To see how wide the gap has grown, one need only go back about a decade. In 2003, Medicare paid hospitals only 16% more, on average, than it paid ASCs. Today, HOPDs receive 81% more than ASCs for the same services. If this proposal is finalized, in 2015, HOPDs would be paid

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