EDITOR'S PAGE
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We can't fault Dr. Yeh for selling out and seeking shelter. But let's
examine why the hospital is forking over a boatload of cash to a sur-
geon it let walk away 3 years ago. It's not the naming rights. The hos-
pital has renamed the ASC St. John's Hospital Surgery Suites. Nor is it
the cataract profits it was surely and sorely missing since Dr. Yeh
hung her shingle across town. Pride of ownership and a booming
book of business are nice, but the real prize is that the hospital now
gets to bill cataract cases at much higher HOPD rates.
For 2014, the Medicare rate for cataract removal with IOL insertion
(CPT 66984) is $959.97 in an ASC and $1,740.50 in an HOPD, a differ-
ence of $780.53. Good intentions and glad reunions aside, Medicare's
cockeyed payment rates are what's driving today's ASC-to-HOPD con-
versions.
Of the 285 ASCs that left the Medicare system from 2009 through
2013, at least 101 were converted to HOPDs, according to the
Ambulatory Surgery Center Association. If Dr. Yeh and her colleagues
perform the same number of cases this year that they did last year
(3,498), St. John's will bill insurers an additional $2.73 million.
Whoever thought that the ASC model would be used as a pawn to
needlessly drive up healthcare costs? OSM
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