Managed Healthcare Executive - February 2009 - (Page 25) { HOSPITALS AND PROVIDERS } ASCs putting the squeeze on acute-care hospitals Increasing outpatient procedures concern hospitals as ASCs take pro t out from under them BY MIKE MCCUE T Mike McCue is a freelance writer based in Cleveland. dures statewide were performed in ASCs in 2007, up from 10.2% in 2000. The Pittsburgh Post-Gazette also reported last month that in Pennsylvania, ASCs signi cantly outnumber acute-care hospitals by a count of 245 to 170. If payers bene t from lower costs and consumers bene t from greater convenience, this trend would seem to be positive—but things are rarely that easy. The nancial impact to acutecare hospitals has become the downside to the ASC trend. On average, the centers see $806 in revenue per outpatient visit, compared with $296 for hospitals, according to the Post-Gazette. In community-based and acute-care hospitals, the revenue generated by joint replacements and colonoscopies, for example, is needed to o set other, less-profitable procedures—including care in the emergency room. “Hospitals are continuing to see physicians take the more pro table ambulatory procedures out of the hospitals and into the ASCs,” says Erica Drazen, a managing partner in the Global Healthcare Sector of Computer Sciences Corp. “Doctors HE EXODUS OF PATIENT CARE from tra- make more money if the procedures are ditional settings has been going on for years as performed in their ASC because they get patients gravitate toward walk-in health clinics to keep both the surgery fee and the faat malls and drug stores across the country. On a cility fee.” higher level, acute-care hospitals are also losing business, with more and more patients choosing to have their UNCOMPENSATED CARE outpatient surgeries performed at ambulatory surgical To further complicate matters, the majorcenters (ASCs). Often, those ASCs are more e cient ity of patients who utilize ASCs tend to and convenient for consumers, and they usually charge have health insurance, leaving hospitals less than hospitals for the same procedures. with a disproportionate number of unThat would explain their growing popularity. A insured and those on Medicaid. Accordstudy of outpatient and diagnostic procedures done ing to the PHC4’s report, the percentby the Pennsylvania Health Care Cost Containment age of uncompensated care performed at Council (PHC4) showed that 30.7% of such proce- hospitals is considerably higher (2.27%) FEBRUARY 2009 Somos/Verr/Getty Images 25
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