MedPAC: Final Recommendations Stand at 0.5% Payment Increase for ASCs in 2013

Ambulatory Surgery Centers

In the Medicare Payment Advisory Commission's annual payment policy report (pdf) to Congress, MedPAC officials recommended that Medicare payments for ASCs increase by 0.5 percent for the 2013 calendar year. MedPAC's recommended payment update for ASCs is lower than the 1 percent it recommended for hospital outpatient departments because there is a lack of cost data from ASCs. MedPAC said cost data from ASCs would help determine the costs of an efficient provider and if an ASC-specific market basket should be developed. MedPAC also recommended that a value-based purchasing program for ASC services be implemented no later than 2016.

In 2010, more than 5,300 Medicare-certified ASCs provided healthcare services to roughly 3.3 million Medicare beneficiaries. In total, the Medicare program spent $2.7 billion on ASC services. MedPAC found that facility and volume growth at ASCs slowed in 2010, due in part to the 2008 financial crisis. In addition, Medicare payment rates in 2012 are 74 percent higher in HOPDs than in ASCs, which may be driving an increase in ASC sales to hospitals.

In the report, MedPAC also wrote the Medicare sustainable growth rate, the system used for updating physician payments, should be repealed as soon as possible. It said a permanent solution is becoming costlier every year, making it more difficult to find feasible offsets. This year, like last year, MedPAC recommended Medicare payment freezes for primary care physicians and annual Medicare rate reductions of 5.9 percent for three years, followed by a payment freeze, for specialty physicians.

More Articles on ASCs and Medicare:

CBO: Medicare, Medicaid Costs to More Than Double Through 2022

CMS Final Rule Increases ASC Payment Rates by 1.6% in 2012, Establishes Quality Reporting Program

The Problem With ASC Reimbursement Methodology: 4 Thoughts From Tri-City Orthopaedic Clinic's Scott Faringer

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