AS I SEE IT
than $38 billion per year in US health care costs. More than $5 billion of this recovery is saved directly by the patient via lower out-of-pocket costs. The study calculated that this savings could grow up to $55 billion if addi- tional procedures migrated to ASCs. “The cost difference can be signif-
icant,” Kampine says. “For a patient like Mike in middle Tennessee, a knee arthroscopy can cost as little as $3,000 in the ASC setting, while equivalent care in the hospital outpatient depart- ment can cost $9,000, or more. This is a major cost savings to the patient pay- ing with a deductible, and in Mike’s case, lower cost may also be an incen- tive to not defer care. Even more sig- nificant is the savings to an employer, whose employees may have dozens or even hundreds of ASC-eligible proce- dures each year. Utilizing cost-effec-
tive ASCs helps hold down health care costs and enables those employers to continue providing valuable benefits.” Another significant trend toward
recognizing value in health care is the shift from fee-for-service payments to value-based payments. Admittedly, “value-based” payments can be defined in many ways, but these payments gen- erally include a component of linking payments to the quality of care while reducing health care costs, both of which are core strengths of the ASC setting. As these programs become more common among both Medicare and commercial payers, ASCs should be well positioned to benefit from this trend, as long as the quality measures are meaningful and reflect value in the eyes of the patient. ASCs are bending the cost curve downward, which should eventually
result in not only lower out-of-pocket costs at the time of a needed surgery for people like Mike Williams, but also reduced health insurance costs for employers, payers and beneficiaries. The rapid increase in high-deductible plans will continue to fuel consumerism, which in turn will send patients rushing to high-quality, lower cost alternatives. The value proposition for ASCs is over- whelmingly strong, and we expect ASCs to thrive in this environment.
Terry Bohlke, CASC, is the immediate past president of the ASCA Board and vice president of ambulatory surgery centers for a health care company in Franklin, Tennessee. Write him at terry_bohlke@chs. net. Brandon Fazio is the director of financial analysis in the ambulatory surgery center department for a health care company. Write him at
brfazio@yahoo.com.
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ASC FOCUS JANUARY 2017 11
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