ASCs are historically reimbursed at lower levels than hospital outpatient departments, despite being considered by many in healthcare to be a high-quality and low-cost site of care.
As operating costs soar, many leaders are concerned about how low reimbursements will affect their ability to meet margins.
Here are five numbers illustrating ASCs' reimbursement challenges:
3.1%. CMS' finalized payment rate for ASCs in its 2024 final rule, a decrease from 2023's 3.8% payment rate.
58%. How much more medical procedures can cost at HOPDs as of 2022 when compared to a physician office or ASC, according to an analysis by Blue Health Intelligence, the Blue Cross Blue Shield Association's data analytics company.
10%. The percentage increase in the cost of a diagnostic colonoscopy at ASCs between 2017 and 2022, compared to 17% at HOPDs, according to the Blue Health analysis.
33%. The amount by which adjusted reimbursement for GI procedures decreased on average from 2007 to 2022, according to a study published in the American Journal of Gastroenterology.
55%. How much higher U.S. hospitals' facility fees for colonoscopy procedures covered by private health insurance are than those at ASCs as of May 2023, according to a Johns Hopkins Bloomberg School of Public Health study published in JAMA Health Forum.