Patients chose ambulatory surgery centers over hospital outpatient departments for cataract removal surgery when they were made aware of the costs of care, according to a study published in Health Affairs, funded by AHRQ.
Here five key insights:
1. Researchers examined the impact of "reference-based benefits," or "reference-based pricing," which is an employer-based health insurance design that encourages patients to select lower-priced freestanding ASCs over HOPDs.
2. Researchers analyzed cataract removal surgeries using data on 2,347 patients covered by the California Public Employees Retirement System in comparison with 14,867 patients enrolled in non-CalPERS Anthem Blue Cross plans, which are not covered by reference-based benefits.
3. The study found that the shift to reference-based benefits for CalPERS patients was associated with an increase of 8.6 percent in ASC use as compared to trends among Anthem enrollees.
4. Also, total employer and employee payments per procedure for CalPERS patients decreased by 19.7 percent compared with Anthem enrollees.
5. Reference-based benefits for cataract surgery saved CalPERS $1.3 million in the two years after implementation.