New Research: How Surgery and Recovery Centers Can Save Patients, Employers, and Taxpayers Billions

|
EXECUTIVE SUMMARY

For too long much of the attention related to health policy has been focused on Washington, D.C. and the details of ObamaCare. This focus is largely misplaced; state policymakers can often play a more immediate role in lowering costs for patients by promoting competition and transparency among health care providers. One place to start is to allow for greater flexibility for patients needing elective surgery.

Ambulatory surgical centers (ASC) and recovery care centers (RCC) have proven to be lower-cost, high-quality care for patients and their employers. According to the U.S. Inspector General at the Department of Health and Human Services, taxpayers would save $15 billion and patients would save $3 billion, for those enrolled on Medicare, if surgeries were paid for at ASC rates, with no impact on quality. We estimate that in the private marketplace, the average family of four would save $525-$874 a year if all outpatient surgeries was paid for at ASC rates.

In addition, research has shown that the care at ASCs, on average, result in faster recovery times, more patient-friendly attention, with many doctors preferring them to an outpatient surgery department at a hospital. Yet, numerous hospitals have engaged in targeted campaigns against ambulatory surgery centers and single-specialty hospitals lobbying for stronger, more restrictive Certificate-of-Need statutes.

Legislators should ignore these efforts, and instead modernize their states’ regulatory framework to reflect the advances in surgery care, and promote a more patient-centered health system. They should exempt ASCs and RCCs from CON, if they are currently restrained, and set up licenses that allow for freestanding and affiliated RCCs if they do not exist. Any new regulations should narrowly address patient safety and protection, and allow for competition to flourish.