Increasing ambulatory surgery center use for diagnostic and preventive services such as colonoscopies could save Medicare and its beneficiaries more than $57.6 billion over the next decade, according to a study conducted by University of California, Berkeley, researchers.
Encouraging ASC use for many procedures would cut costs because Medicare reimburses ASCs 58 percent lower, on average, it pays hospital outpatient departments for the same procedures, according to the report. For instance, Medicare paid ASCs $951 for cataract surgery in 2011, compared with $1,691 it reimbursed HOPDs. The lower reimbursement rate means patients also pay a smaller coinsurance.
Through patients having procedures performed at ASCs rather than in HOPDs, the researchers found the Medicare program saved $6 billion and beneficiaries saved $1.5 billion from 2008 to 2011. In 2011, the share of total Medicare procedures performed in ASCs was 21.7 percent.
If the Medicare procedure volume and share for ASCs remains constant, the facilities will save another $32.5 billion from 2013 to 2022. However, the study found those savings could reach $57.6 billion if the volume of procedures increases by 3 percent annually and the ASC share goes up by either 1 percent, 5 percent of 10 percent annually, depending on the procedure.
Policymakers should consider these results when making decisions about containing healthcare costs and reducing the federal budget deficit, according to the researchers.
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