News & Research

Changes in Hospital–Physician Affiliations in U.S. Hospitals and Their Effect on Quality of Care

According to a study published in Annals of Internal Medicine, during the past decade, hospitals have increasingly become employers of physicians. The study's findings suggest that physician employment alone probably is not a sufficient tool for improving hospital care.
Read More >

 

Commercial Insurance Cost Savings in Ambulatory Surgery Centers

A review of commercial medical-claims data found that U.S. healthcare costs are reduced by more than $38 billion per year due to the availability of ambulatory surgery centers (ASCs) as an appropriate setting for outpatient procedures. More than $5 billion of the cost reduction accrues to the patient through lower deductible and coinsurance payments. This cost reduction is driven by the fact that, in general, ASC prices are significantly lower than hospital outpatient department (HOPD) prices for the same procedure in all markets, regardless of payer.
Read More >

 

Medicare Cost Savings Tied to ASCs

Analysis by researchers at the University of California-Berkeley Nicholas C. Petris Center on Health Care Markets and Consumer Welfare finds that ASCs provide billions of dollars in savings to the Medicare program and its beneficiaries. Specifically, Berkeley’s researchers found that ASCs saved Medicare $7.5 billion over the four-year period from 2008 to 2011. Going forward, ASCs have the potential to save the Medicare system an additional $57.6 billion over the next decade.
Read More >

 

ASCs Perform Procedures More Efficiently and at Lower Cost

When compared to procedures performed in hospital outpatient departments, ASCs perform those same procedures, on average, 31.8 minutes faster, according to a study published in Health Affairs. Therefore, ASCs can perform more procedures per day and generate savings of $363-$1,000 per outpatient case. Consequently, increased use of ASCs would generate substantial savings and improve the quality of health care delivery.
Read More >

 

Reference Pricing Causes Patients to Choose ASCs for Orthopedic Surgery

The California Public Employees Retirement System’s (CalPERS) implemented reference-pricing benefit designs, which requires employees to pay the difference between the actual price of a procedure and the employer’s contribution limit. According to a study, the impact of this change in benefit design was that more employees choose a lower cost setting, such as an ASC, in which to have their procedure performed. The study also noted that after the policy change higher priced facilities began to reduce prices.
Read More >

 

Cataract Patients Choose ASCs in Reference-Based Benefit Model

According to a study on the effects of California Public Employees Retirement System’s (CalPERS) change in coverage policy, most patients elected to have their cataract removal procedures done in a lower cost setting such as an ASC. In addition, the study also found that hospitals, which typically charge more for same-day surgical procedures, began to lower their prices in response to more and more patients choosing ASCs for their surgical care.
Read More >

 

Hospital-Owned Organizations More Expensive than Physician-Owned Organizations

According to a study conducted on 158 California organizations between 2009 and 2012, “hospital-owned physician organizations incurred higher expenditures for commercial HMO enrollees for professional, hospital, laboratory, pharmaceutical, and ancillary services than physician-owned organizations.”
Read More >

 

ASCs a Valued Component of New Jersey’s Economy

ASCs provide $3.68 billion in economic activity and $73 million in tax dollars in the state of New Jersey. They are an important element of the state’s system and economy, a study finds.
Read More >

 

OIG Study Recommends Leveling HOPD, ASC Pricing

Medicare could generate savings of as much as $15 billion for calendar years 2012 through 2017 if the Centers for Medicare & Medicaid Services reduces hospital outpatient department (HOPD) payment rates for ASC-approved procedures to ASC payment levels for procedures performed on beneficiaries with low-risk and no-risk clinical needs, according to a study conducted by the Office of Inspector General.
Read More >

 

Study Confirms Colonoscopy Saves Lives

Funded by the National Cancer Institute and others, a study published in The New England Journal of Medicine found that colonoscopy cut the death rate from colorectal cancer by 53 percent.
Read More >

 

Understanding Costs, Prices and Spending in Health Care

To build an accountable health care system and achieve value, costs to deliver patient care must be tracked. Measurement of price, cost and spending will help consumers understand their options and enable them to negotiate and make informed decisions.
Read More >

 

ASC Growth Not Directly Related to Increased Medicare Utilization

According to a study published in The American Journal of Gastroenterology, the association between ASC growth and service utilization is not necessarily strong. ASC growth is associated with increased total utilization for colonoscopy only. For other common ASC procedures, such as cataract, arthroscopy and upper GI, increased Medicare utilization was not a result of ASC growth.
Read More >