More now than in the
past, the soaring cost of hospital care is leading physicians and patients to
look for different venues for medical treatment. The average cost of a hospital
stay in 2010 was $9,700, whereas for Americans ages 65 to 84 that number soared
to $12,300. It is not surprising that an increasing number of patients are
choosing to undergo procedures in Ambulatory Surgery Centers (ASCs), rather
than in typical hospital settings. Colonoscopies, for example, one of the more
common services provided by ASCs, cost patients on average a co-payment of just
$76. A similar operation in a hospital, meanwhile, can cost the patient $186.
While ASCs offer many benefits, there are a few key trends transforming the ASC
industry which physicians, from surgeons to CRNAs to anesthesiologists,
and their patients should be acquainted with.
Since the first
Ambulatory Surgery Center was established in 1970, ASCs in the United States
have collected less reimbursement from Medicare than hospitals have for
carrying out identical procedures. ASCs collect on average only 49% of the fees
earned by hospitals and hospital-affiliated centers. For example, an ASC will
receive a payment of only $980 for conducting a cataract surgery, whereas a
hospital which performs the same operation will earn $1,760. This could change
in the near future, however. Government health officials are working to
eliminate the payment disparity between hospitals and ASCs in order to foster
the growth of the ASC industry. The ASC Access and Quality Act of 2017,
introduced in the House of Representatives in March of 2017, seeks to ensure
fair compensation for ASCs. Moreover, the newly appointed chief of the Department
of Health and Human Services, Secretary Tom Price, has a track record of
supporting ASCs. He once owned an ASC himself, and worked as an orthopedic
surgeon before he was elected to Congress. In his new role he may try to
promote ASCs as a high-quality and cost-effective health care option for
patients
.
ASCs
are well-known for their autonomy, but a recent trend in the medical industry
could change this. Hospitals have ownership stakes in just 21 percent of ASCs,
and fully own only 3 percent of ASCs, whereas 90 percent of ASCs are owned in full or in
part by surgeons and physicians. Over the last few years, however, prominent
insurers and hospitals have made efforts to purchase ASCs in order to extend
their presence in the healthcare market. ASCs are known for being small, local
businesses – almost 70% of ASCs employ 20 people or fewer. If insurers and
hospitals continue to buy ASCs this could change, however. ASCs could become
more profitable as a result of these mergers, though, as they would have access
to more capital and be able to procure supplies at lower costs. The future of
ASCs in the United States is not certain, but these developments provide clues
as to how the industry will likely change in coming years.
