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ADVOCACY SPOTLIGHT


the results online in a “side-by-side comparison.” The publicly available data would include quality measures for both sites of service in the same geographic area, enabling patients to easily research the best site of service for their needs. Add an ASC representative to the


Advisory Panel on Hospital Outpa- tient Payment (HOP Panel). Since decisions made by the panel impact ASC facility fees and the list of pro- cedures that Medicare will reimburse ASCs for providing, ASCs—like hos- pitals—should have an industry rep- resentative on the panel. This provision is important; as the


panel evaluates hospital payments and inpatient procedures, it will be cru- cial for ASCs to have an advocate who understands the high-quality, cost-effi- cient care that ASCs provide. In 2016, the panel recommended that CMS move total knee arthroplasties from the Medicare inpatient only list to the outpatient list, paving the way for the procedures to be performed in the ASC setting. As more of these recommenda- tions occur within the panel, the ASC perspective must be represented. Disclose the criteria used to omit


individual procedures from the ASC procedure list. Currently, CMS can exclude a procedure from the ASC procedure list because of a general concern related to eight criteria. CMS, however, is not required to disclose which of the criteria triggers the exclu- sion for a given procedure. By refusing to disclose which cri- teria it believes ASCs fail to meet, CMS makes it difficult for ASCs to marshal the data needed to challenge these decisions. The ASC Quality and Access Act would require CMS to dis- close which of the criteria triggers the exclusion and prohibits CMS from excluding procedures reported with unlisted codes from the ASC setting. Adding procedures that can be per- formed safely in an ASC setting to this


ASC FOCUS APRIL 2017 23 ASCs Provide Substantial Savings to Medicare and Its Patients


ASCs offer considerable cost savings to patients, commercial insurers and Medicare. According to a US Department of Health and Human Services Office of Inspector General (OIG) report published in 2014, ASCs saved Medicare $7 billion from 2007 to 2011 and were projected to save Medicare another $12 billion between 2012 and 2017. Medicare beneficiaries save through lower copays.


Academic research corroborates these findings. The University of California at Berkeley’s study, “Medicare Cost Savings Tied to Ambulatory Surgery Centers,” found that ASCs saved the Medicare program and its beneficiaries $7.5 billion from 2008 to 2011.


list saves Medicare and its beneficia- ries money. The provisions in the Ambulatory


Surgical Center Quality and Access Act would help ensure that ASCs can continue to care for Medicare patients. In addition to this legislation, ASCA engages Congress on a variety of priorities that impact ASCs. For more


information on the Ambulatory Surgical Center Quality and Access Act and ASCA’s other legislative priorities, go to www.ascassociation.org/govtadvocacy/ legislativepriorities.


Kristin Murphy is ASCA’s assistant director of legislative affairs. Write her at kmurphy@ascassociation.org.


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