Help Support Your ASC Get to know the new ASC Quality and Access Act BY KRISTIN MURPHY


ecent studies (see sidebar on page 23) prove what the ASC indus-

try already knew: ASCs provide sig- nificant savings to Medicare and its beneficiaries. A growing disparity in payments between ASCs and hospi- tal outpatient departments (HOPDs), however, is jeopardizing both the industry and patient access to high- quality, cost-efficient care. Over the past decade, ASCs were subjected to a six-year payment rate freeze and payment updates that were determined using an inflation measure unrelated to the true costs of providing health care services. This contributed to a substantial drop in ASC payments in comparison to HOPD rates. In 2003, ASCs were paid 84 percent of the hos- pital rate. Today, ASCs are paid just 49.9 percent for the same procedures that hospitals perform. The Ambulatory Surgical Center

Quality and Access Act of 2017, spon- sored by US Representatives Devin Nunes (R-CA) and John Larson (D-CT), and Senator Mike Crapo (R-ID), seeks to ensure that the Medicare program and its beneficiaries continue to receive the surgical and preventive care that more than 5,400 Medicare-certified ASCs across the nation provide. The ASC Quality and Access Act of 2017 would enact the following reforms:

Update reimbursement for ASC

services using the same update fac- tor as HOPDs—the hospital market basket. Medicare payments to ASCs, in comparison to hospitals, will drop to a record low in 2017. This payment disparity exists, in part, because ASC payment rates are updated using the Consumer Price Index for All Urban Consumers (CPI-U), while HOPD pay- ment increases are based on the hospi-


The provisions in the Ambulatory Surgical Center Quality and Access Act would help ensure that ASCs can continue to care for Medicare patients.”

—Kristin Murphy, ASCA

tal market basket. The CPI-U measures the rising cost of goods and services such as bread and gasoline and does not appropriately measure the increase in costs in an ASC. The hospital mar- ket basket is based on factors directly related to the increasing costs of pro- viding medical care, which impacts both hospitals and ASCs. Since there are no significant differences in the cost of goods and services provided by ASCs and HOPDs, the same update mechanism should apply. The ASC Quality and Access Act would require the Centers for Medi-

care & Medicaid Services (CMS) to update ASC payments according to the more appropriate hospital market bas- ket. ASCs would remain a source of savings, but the disparity in payment rates would not continue to expand. Create transparency of quality

reporting and Medicare beneficiary information. Both ASCs and HOPDs that treat Medicare patients are required to submit quality data based on measures established by CMS. In the event that a measure is applicable to both the ASC and the HOPD set- tings, CMS would be required to post

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