Repricing Specialty Hospital Outpatient Services Using Ambulatory Surgery Center Prices

This article explores whether Medicare pays more for the same outpatient services provided in an acute specialty hospital than in an ambulatory surgery center (ASC). How financially dependent a specialty hospital is on ASC-eligible services is also investigated. Medicare outpatient claims in 43 orth...

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Main Authors: Healy, Deborah, Cromwell, Jerry, Thomas, Frederick G.
Format: Online
Language:English
Published: CENTERS for MEDICARE & MEDICAID SERVICES 2007
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195025/
id pubmed-4195025
recordtype oai_dc
spelling pubmed-41950252014-11-04 Repricing Specialty Hospital Outpatient Services Using Ambulatory Surgery Center Prices Healy, Deborah Cromwell, Jerry Thomas, Frederick G. Also Featuring… This article explores whether Medicare pays more for the same outpatient services provided in an acute specialty hospital than in an ambulatory surgery center (ASC). How financially dependent a specialty hospital is on ASC-eligible services is also investigated. Medicare outpatient claims in 43 orthopedic and 12 surgical specialty hospitals in 2004 were repriced using ASC pricing software. Payments for the same surgical procedure were 43 and 64 percent higher in specialty surgical and orthopedic outpatient departments, respectively, compared with simulated ASC payments. Non-ASC-eligible outpatient services were 18-35 percent of all Medicare outpatient payments varying by type of specialty hospital. CENTERS for MEDICARE & MEDICAID SERVICES 2007 /pmc/articles/PMC4195025/ /pubmed/18435225 Text en
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Healy, Deborah
Cromwell, Jerry
Thomas, Frederick G.
spellingShingle Healy, Deborah
Cromwell, Jerry
Thomas, Frederick G.
Repricing Specialty Hospital Outpatient Services Using Ambulatory Surgery Center Prices
author_facet Healy, Deborah
Cromwell, Jerry
Thomas, Frederick G.
author_sort Healy, Deborah
title Repricing Specialty Hospital Outpatient Services Using Ambulatory Surgery Center Prices
title_short Repricing Specialty Hospital Outpatient Services Using Ambulatory Surgery Center Prices
title_full Repricing Specialty Hospital Outpatient Services Using Ambulatory Surgery Center Prices
title_fullStr Repricing Specialty Hospital Outpatient Services Using Ambulatory Surgery Center Prices
title_full_unstemmed Repricing Specialty Hospital Outpatient Services Using Ambulatory Surgery Center Prices
title_sort repricing specialty hospital outpatient services using ambulatory surgery center prices
description This article explores whether Medicare pays more for the same outpatient services provided in an acute specialty hospital than in an ambulatory surgery center (ASC). How financially dependent a specialty hospital is on ASC-eligible services is also investigated. Medicare outpatient claims in 43 orthopedic and 12 surgical specialty hospitals in 2004 were repriced using ASC pricing software. Payments for the same surgical procedure were 43 and 64 percent higher in specialty surgical and orthopedic outpatient departments, respectively, compared with simulated ASC payments. Non-ASC-eligible outpatient services were 18-35 percent of all Medicare outpatient payments varying by type of specialty hospital.
publisher CENTERS for MEDICARE & MEDICAID SERVICES
publishDate 2007
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195025/
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