Outpatient Surgery Magazine

Helping Hand - July 2019 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 28 of 128

Same inflationary measures Historically, CMS used an economic measure known as Consumer Price Index for All Urban Consumers (CPI-U) to update ASCs for inflation each year, but updated HOPDs using a different measure, the Hospital Market Basket. The differences between CPI-U and Hospital Market Basket are profound. • CPI-U. A broad measure that looks at the things we buy — heating oil and home prices, milk and bread, for example — and has very lit- tle to do with health care. • Hospital Market Basket. Looks at the costs of goods and services used in health care and reflects what the inflation in those have been. As a result, most years — because medical inflation outpaces over- all inflation — the gap between the inflationary rate that the hospitals received and what the ASCs got was getting larger and larger. Besides ASCs falling further and further behind HOPDs, the fallout included hospitals buying the ASC down the street and flipping it into a hospital outpatient department so they could get the higher reim- bursement rate. CMS has finally agreed to update ASCs using the same inflation fac- tor. For the next 5 years, CMS will update ASCs using the Hospital Market Basket. As a result of that, ASCs this year received their largest inflationary increase — 2.1% — over the past decade. Getting ASCs off the CPI-U is a great first step in terms of trying to decrease the payment disparities between surgery centers and other settings. Separate medical device payment We also made some progress in Medicare's device-intensive threshold policy, which dictates when an ASC can be reimbursed for the cost of a medical device. 1 2 J U L Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 2 9

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