A new study published in the Journal of Bone and Joint Surgery shows patients prefer outpatient ambulatory surgery centers to hospital outpatient facilities, partially due to lower costs associated with ASC procedures.
Researchers gathered data from 3,962 patients in the California Public Employees' Retirement System who underwent knee arthroscopy or shoulder surgery in the three years before implementing reference-based benefits and compared them to 2,505 CalPERS patients who had surgery in the two years after implementation. There was also a control group of 57,791 patients who did not have reference-based benefits.
The researchers found:
1. In the second year of the program, there was a shift towards freestanding ASC use. ASC utilization increased 14.3 percentage points for knee arthroscopy and 9.9 percentage points for shoulder arthroscopy.
2. When the ASCs experienced an increased utilization, hospital-based outpatient facilities showed a decrease in utilization.
3. The average price for a CalPERS beneficiary fell 17.6 percent for knee procedures and 17 percent for shoulder procedures.
4. The reference-based benefits shift wasn't associated with a surgical complication rate change.
5. In the two years after reference-based benefits, CalPERS saved $2.3 million — or 13 percent — on knee and shoulder arthroscopies.