Ambulatory Surgery Centers 'Pivotal' in Moving Outpatient Surgical Services Into...

Ambulatory Surgery Centers 'Pivotal' in Moving Outpatient Surgical Services
Into Less Expensive, Clinically Appropriate Settings

ALEXANDRIA, Va., June 16 /PRNewswire-USNewswire/ -- Ambulatory surgery centers
(ASCs) play a pivotal role in moving services into less expensive yet
clinically appropriate settings, concludes a study issued today by the
independent health economics and policy firm KNG Health Consulting. Other key
findings from the study, which examined the growth in the number of ASCs
between 2000 and 2007, include:

-- ASCs are essential Medicare providers of surgical and cancer screening
services.
-- 70% of the growth in Medicare services provided by ASCs between 2000
and
2007 is the result of moving procedures from hospital outpatient
departments (HOPDs) into the less expensive ASC setting.
-- For gastrointestinal and ophthalmology services -- two major types of
services ASCs provide -- 75% and 94% of the growth, respectively, in
ASC
services over the study period is from the migration of services into
the less expensive ASC setting.

-- Unlike what some critics suggest, ASCs do not result in a higher
overall
surgical volume.

"For some time, the ASC community has maintained that the key reasons ASCs are
in such high demand with physicians and their patients are the high-quality
surgical services, topnotch patient care and cost-effective alternative they
offer," said ASC Association Chair Alsie Sydness-Fitzgerald, CASC. "This
research confirms what we have known for a long time. This study clearly shows
that policies that support ASCs should be a part of any health care reform
plans the current Congress and Administration adopt."

"With this study, we now have the data we need to conclusively demonstrate
that ASCs have long been playing a critical role in meeting America's surgical
needs," said Richard E. Francis, Jr., chair of the ASC Coalition, an
organization of ASC associations and companies that commissioned the study,
and chief executive officer and director of Symbion, an ASC management and
development company. Some of the other important conclusions that can be drawn
from the research findings, adds Francis, include:

-- ASCs have been a beneficial partner to Medicare and its beneficiaries
in
constraining spending growth by providing a lower-priced option for
outpatient surgical needs.

-- The health care reform objectives articulated by the US Congress and
the
Administration -- promoting efficient use of services in the health
care
system and improving the value of Medicare's spending -- are
inextricably linked to promoting the use of ASCs for beneficiaries'
outpatient surgical needs.

To enable ASCs to continue playing a positive role in the migration of
services into less expensive outpatient settings, the ASC Association is
supporting H.R. 2049, the Ambulatory Surgical Center Access Act of 2009. The
bill ensures that:
-- Medicare will always save more than 40% in ASCs when compared to
HOPDs.

-- Patients will be able to compare the price and quality of services
ASCs
and HOPDs provide.

The ASC Association is a national, nonprofit association that represents the
interests of those who own, operate and seek the services of ASCs throughout
the nation. The organization represents more than 2,500 ASCs, the
professionals who provide care in such ASCs and the patients who seek care
there. Visit the association online at www.ascassociation.org.

ASC Coalition Fact Sheet

Report Details Positive Contribution of ASCs to Health Care Reform Goals

A report by KNG Health Consulting provides evidence that ambulatory surgical
centers (ASCs) play a pivotal role in moving services out of hospitals and
into less expensive yet clinically appropriate settings. The study findings
highlight the role ASCs have played in meeting the growing population needs
for essential surgical and cancer screening services. The use of ASCs has
likely slowed growth in total Medicare spending for outpatient surgical
services because they offer a low-cost alternative to hospital outpatient
departments (HOPDs), a goal the ASC industry suggests is consistent with the
Administration's health reform priorities.

The health reform objectives articulated by the Congress and the
Administration -- promoting efficient use of services in the health care
system and improving the value of Medicare's spending -- are inextricably
linked to promoting the use of ASCs for beneficiaries' outpatient surgical
needs. The results of this research demonstrate that ASCs have already been a
beneficial partner to the Medicare program and its beneficiaries in
constraining Medicare spending growth by providing a lower-priced option for
outpatient surgical needs. The reforms discussed in Congress should provide
further incentives to move additional clinically appropriate surgeries into
ASCs at a savings to the beneficiary, Medicare program and U.S. taxpayers.

The ASC Coalition contracted with KNG Health Consulting to identify the
factors that have contributed to the growth of ASCs. In addition, the
researchers were asked to measure the growth factors and estimate the relative
contribution of each factor. In general, the researchers found that most of
the growth of the industry between 2000 and 2007 was fueled by the movement of
many gastrointestinal (GI) and ophthalmology services into ASCs from hospital
outpatient departments.

Beyond demonstrating the role ASCs have played in moving surgical services
into less expensive settings, this study disproves two factors critics of the
ASC industry have suggested may offset the cost reducing effects of the
relatively low Medicare payment rates for ASCs.

First, some ASC critics have suggested that physicians who own ASCs have a
financial incentive to perform more surgical services than they would if they
could only provide outpatient surgical services in a HOPD. It has also been
suggested that the expansion of outpatient surgical capacity in ASCs may lead
to a higher overall volume of outpatient surgery.

This study found no statistical evidence that ASCs cause an increase in
utilization of common Medicare procedures like colonoscopies and cataract
surgery.

In fact it shows that 70% of the growth in ambulatory surgery centers from
2000 to 2007 is the result of moving procedures from HOPDs into the less
expensive ASC setting.

One exception to the migration trend is pain management services. The study
noted that significant changes in insurance coverage and advancement in the
pain management clinical treatments have evolved in the past 5 to 7 years.
Taking these evolutionary events into context, the growth rate for pain
management procedures in ASCs is consistent with the growth rate for pain
management procedures across all other modalities.

The report also finds that:
-- Growth in factors completely external to the ASC industry, such as the
number of Medicare beneficiaries and disease prevalence help explain
the
total trend and demonstrate the role of ASCs in meeting demographic
challenges for Medicare.
-- An increase in the number of necessary and appropriate services per
beneficiary is the primary element of spending growth. Most of this
growth (70%) is explained by migration of services from the HOPD to
the
ASC. The remaining 30% is a function of population growth, increased
prevention, expanded insurance coverage, and new technologies.

-- Much of the growth in ASC spending has been in procedures whose volume
increases are relatively slow.

Taken together, the research suggests that public policies promoting the
expansion of ASC capacity have helped ensure access to essential surgical and
cancer screening services at a savings to the Medicare program and its
beneficiaries and should be an important contribution to achieving health care
reform goals.

For more information, contact Marian Lowe at 202.266.2606 or
marian.lowe@shcare.net.

SOURCE ASC Association

Kay Tucker of ASC Association, +1-703-836-8808, ktucker@ascassociation.org