In states with fee schedules, ASCs are often more competitive than hospitals on price, though not always.
Ambulatory surgery centers have new evidence to back up arguments for its relative cost-effectiveness.
A new study from the Workers Compensation Research Institute comparing surgery payments for ambulatory centers and hospital outpatient centers has found that ambulatory centers often, but not always, have lower prices, especially in states with fee schedules.
The study supports “the conventional wisdom that ASC surgeries are less expensive than hospital outpatient surgeries,” said Bogdan Savych, PhD, a policy analyst at the Workers Compensation Research Institute and author of the report, in a press release.
Fee schedule rates are more predictable in states with fixed fee schedules, the study found by examining payments for common shoulder and knee surgeries performed in 23 states in 2011.
In Florida, Michigan and Pennsylvania, which all have fixed fee schedules for ASCs, ASC surgeries were less expensive than those at hospital outpatient facilities, which are paid based on charges submitted to payers.
ASC payments for knee arthroscopies, for example, were less than $2,000 in Pennsylvania, Michigan, Maryland and New York, and more than $6,000 in Indiana, New Jersey, Virginia, Missouri, Illinois, Connecticut and Louisiana.
In states with fee schedules for both ASC and hospital outpatient surgeries, payments for the two different facilities were often similar, the study found.
In states without fixed-amount fee schedules, though, the price differences were less predictable – and in some states ASCs were more expensive for most or for some procedures.
The study found that ASC surgeries in Connecticut were more expensive than hospital outpatient surgeries, while ASCs in Georgia, New Jersey, North Carolina and Tennessee had higher prices for some procedures.