MEDICARE MONITOR
little to capitalize on the cost-saving potential of ASCs. Instead, by failing to increase ASC rates adequately to keep pace with medical inflation, doing nothing to stem the growth in disparity between ASC and HOPD payments and treating the increasingly similar clinical settings of ASCs and HOPDs differ- ently in determining what procedures to pay for, the agency has discouraged ASCs as a solution. The president, Congress and state
governments might not be as dif- ficult to convince of the wisdom of taking advantage of the cost savings that ASCs offer when faced with the mounting necessity to reduce health care spending. In fact, these groups have already shown a recent willing- ness to evaluate spending on a more systemic level. For example, some
Extensive savings could be realized by allowing ASCs to perform all clinically appropriate procedures for Medicare beneficiaries.
members of Congress and the Medi- care Payment Advisory Commission have recently begun to question the wisdom of continuing to pay different sites of services differently when they perform the same services. Recently, states like Oregon have also taken a keener interest in leveraging ASCs to reduce Medicaid costs. A willingness to evaluate spending on a more systemic level will not au- tomatically translate into policies that are more favorable to ASCs. Instead, if ASCs are not fully engaged in these discussions, they could easily be over-
looked. Or worse, arguments, as spe- cious as they may be, that ASCs actually bend the cost curve in the other direc- tion by encouraging over-utilization of care could gain traction. ASCs certainly have much to gain if the federal government and the states adopt more favorable policies. Ultimate- ly, whether ASCs will be promoted as a solution, ignored or seen as contribut- ing to the problem will depend on how successful ASCs are at controlling the narrative about their place in the rapidly evolving US health care system.
ASC FOCUS JANUARY 2013
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