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Now is the Time to Support Ambulatory Surgery Centers

By William Prentice, CEO of the Ambulatory Surgery Center Association

As we start to prepare for the second half of 2013, key indicators and projections for the US economy continue to fluctuate. Although Wall Street showed significant gains in the early part of the year and some analysts are predicting continued slow but steady progress toward a full economic recovery, others are projecting more challenging times ahead. Meanwhile, Congress remains consumed with concerns about the US deficit and ways to control government spending. States, too, are struggling to rein in costs and stretch their budget dollars further.

While the policy debates driven by this financial uncertainty affect every sector of government and private spending, nowhere are they more apparent than in health care. Given that the White House’s Council of Economic Advisers (CEA) estimates that this sector of the US economy accounted for nearly 18% of the spending tied to the US gross domestic product (GDP) in 2011, the concerns about rising health care costs that have been raised in the media, on Capitol Hill and in state capitals across the country are no surprise. Given the CEA’s earlier projection that this spending could easily reach 34 percent of the GDP by 2040, these concerns aren’t likely to go away any time soon.

To reduce the cost of health care and minimize its impact on patient access to quality care, economists, policy makers, business management experts and others have suggested— and in some cases, already implemented—a multitude of widely varied solutions. Reliable assessments of the many plans that are being proposed are more difficult to find. For example, while one analyst suggests that integrating electronic health records more fully into the US health care system will lower the costs of providing care, another says these systems will cause costs to increase.

Meanwhile, as the White House points to signs that health care reform has already begun to slow the growth of health care costs and improve quality of care, private employers, health care providers, insurers and patients are still trying to determine what effect the expansive Patient Protection and Affordable Care Act adopted in 2010 will have on them tomorrow and into the future. Will Accountable Care Organizations push independently owned providers out of the market? Will costs rise as consolidation in the industry continues to escalate? What will all of these changes mean for the costs that Medicare beneficiaries and those who are privately insured will incur? Most importantly, will patients gain or lose when it comes to access, quality and affordability of the health care services that they need?

Even in these uncertain times, there is a clear answer for patients seeking low-cost, high quality surgical care: ambulatory surgery centers (ASC). Not only do ASCs continue to provide services at substantial savings—56 cents on the dollar for Medicare beneficiaries— they also offer top quality care and outstanding customer service. At the same time that they are leading innovation and the evolution of surgical care, they have a track record that demonstrates reliability, high patient and physician satisfaction levels and outstanding patient outcomes. They are also small businesses that employ residents of their local communities and pay taxes.

Any way you look at them, ASCs offer benefits to their patients and communities, and both state and federal policy makers should be looking for ways to encourage patient access to the care and cost savings ASCs provide.

Concerns about cost control in the US economy, of course, extend well beyond the health care sector. As I write this column, payment cuts to nearly all federal programs, including health care providers that serve Medicare beneficiaries, are set to take effect on April 1, 2013. These cuts are tied to sequestration—the result of a failed attempt to control federal spending in 2012. For ASCs, the two percent cuts that will be applied to Medicare reimbursements mean that even though the costs of providing health care continue to rise, a .6 percent increase in reimbursements to ASCs approved by Medicare beginning on January 1, 2013, will become a 1.4 percent reduction this year. Because Medicare policy is often reflected later in private insurance contracts that affect patients outside the Medicare system, the effects of these cuts are likely to be felt even more widely over time.

Because they fail to take cost and quality into account, the cuts related to sequestration that will affect all Medicare providers this year are poor public policy and a losing proposition for Medicare and its beneficiaries. Instead, the federal government, and policy makers across the country, should be supporting policies that support those who are providing cost-effective, top quality care. When it comes to same-day surgical care, the answer is clear. Our nation’s legislators and regulatory officials should be supporting policies that support ASCs.

William Prentice is the chief executive officer of the Ambulatory Surgery Center Association.

For more information about the association, call 703.836.8808 or go to



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