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GAO supports surgical center payment shift

This article was originally published in The Gray Sheet

Executive Summary

Long-awaited 1report from the Government Accountability Office confirms appropriateness of tying CMS ambulatory surgical center payments to hospital outpatient payments. The Nov. 30 report examines data from 290 ASCs on 20 common procedures. GAO concludes that costs are significantly lower for procedures performed in the ASC setting, but stops short of recommending a specific conversion ratio. CMS recently proposed a rule to link the two payment systems in 2008, paying ASCs 62% of outpatient levels (2"The Gray Sheet" Nov. 13, 2006, p. 13). The Medicare agency says the 62% conversion factor is based on budget neutrality and assumptions about the migration of procedures from one setting to another, not on relative costs of services. A final rule taking stakeholder comments into account is expected out in the spring...

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