By William Prentice, ASCA Chief Executive Officer
With a new administration in the White House, a new secretary at the U.S. Department of Health and Human Services and health care front and center in the Congressional debate, one thing is certain – more change is on the horizon.
With change comes opportunity, so at ASCA, we’ve put together a short ASC Wish List for the new Administration.
Number one on that list is to put an ASC payment policy in place that ensures that ASCs’ annual Medicare payment updates equal the Medicare payment updates hospital outpatient departments (HOPD) receive each year. This is not a new request, but it is a critical one.
As we have said before, ASC payment updates that are based on the Consumer Price Index for All Urban Consumers (CPI-U), as ASC updates are today, do not reflect the rising costs of health care. The hospital market basket used to determine HOPD payment updates today more accurately reflects the increasing costs that ASCs are encountering as they work to continue to provide the high quality care they have always been known for. Payment updates that would stop the growing divergence between ASC and HOPD payment rates would go a long way toward ensuring that Medicare beneficiaries have continued access to the top-quality, lower cost care that ASCs provide.
In his first days in office, President Donald Trump has clearly established his intention to reduce some of the federal administrative and regulatory burdens that have been imposed on health care providers and others over time. In keeping with that idea, we propose that the Centers for Medicare & Medicaid Services (CMS) do away with the ASC approved procedures list. Instead, Medicare should simply reimburse ASCs for all of the procedures that it reimburses HOPDs for providing.
Producing and maintaining a separate list of approved procedures for ASCs adds a layer of bureaucracy to the Medicare program that is simply unnecessary given the quality and safety records associated with ASCs and the other quality assurance systems already in place. In fact, ASCs are already performing many procedures that are not on Medicare’s approved procedures list for their privately insured and self-paying patients and achieving outstanding outcomes for those patients. The approved procedures list does little more than prevent Medicare beneficiaries from gaining access to that same care in the more affordable, higher value ASC setting.
During his presidential campaign, in his inaugural speech and since he has been in office, one of the most consistent messages President Trump has sent is his deep-seated support for U.S. businesses. As small businesses that employ local residents, pay taxes and support development and activities in their communities, ASCs are the embodiment of many of the goals this administration has put forth in that area. At the same time, ASCs offer extensive benefits to patients, physicians and the future of outpatient surgery that are entirely disconnected from the political landscape. We ask that this new administration back the policies that help ASCs survive and thrive, and we stand ready to work with President Trump and his team whenever possible to help define those policies.
To make certain that President Trump and his staff and advisers are fully aware of the cost savings that ASCs can provide, we point to two important studies conducted in recent years. The first, conducted by researchers at the University of California-Berkeley, shows that ASCs save Medicare and its beneficiaries $2.3 billion per year. The second was conducted by national health care quality and cost data provider Healthcare Bluebook in partnership with the nation’s largest independent administrator of health plans for self-funded employers HealthSmart. That study shows that ASCs currently save commercial and employer-sponsored plans and their beneficiaries more than $38 billion per year. In both cases, the studies revealed ASCs have ample capacity to do more.
Cutting the cost of health care while maintaining the quality of that care and offering expanded choice and access to care is not a partisan issue. Members of Congress from both sides of the aisle support the ASC model of care and the steady progress ASCs are making toward further improvements in outpatient surgical care. Our Wish List includes the hope that this administration will capitalize on the broad-based support ASCs enjoy and encourage policies, like price transparency and systems that support informed consumers, that will encourage more procedures to move into the ASC setting.
As the conversations in Washington, D.C., that will determine the future of the U.S. health care marketplace continue, we invite all members of the ASC community to join ASCA at our annual meeting, ASCA 2017, this year in Washington, D.C., May 3-6. We are inviting all of our meeting participants to join us in visits to Capitol Hill where we will be meeting with members of Congress and advocating for the policies ASCs need in place to be able to continue to offer both Medicare and non-Medicare patients the high-value outpatient surgical services ASCs provide.
William Prentice is the chief executive officer of the Ambulatory Surgery Center Association.