The Medicare Payment Advisory Commission says ASCs don't deserve an inflation adjustment in Medicare's 2010 payment rates, according to Outpatient Ophthalmic Surgery Society lobbyist Mike Romansky, JD. He says several MedPAC commissioners spoke in favor of recommending to Congress that ASCs receive no cost-of-living update for a seventh straight year.
MedPAC - an independent agency that advises Congress on issues affecting the Medicare program - cites a $1 billion increase in aggregate Medicare payments to ASCs in 2009, with the annual addition of 250 certified ASCs and growth in publicly traded surgery centers as evidence of a strong industry that does not need a cost-of-living update, according to Mr. Romansky.
"If there was any indication whatsoever that payment rates are in excess of what they should be, we could have an intelligent conversation with MedPAC," says Kathy Bryant, president of the Ambulatory Surgery Center Association. "This is potentially bad news, but it's not a final decision. We're involved in extensive conversations with MedPAC" to change the agency's view before it renders a final ruling in March.
She says that while publicly traded corporate partners might be doing well, more than 80 percent of surgery centers are small facilities struggling to survive hard economic times. "With just a modest cost-of-living increase - the same received by hospitals - Medicare could save 41 percent for every procedure performed in an ASC," says Ms. Bryant, who adds that MedPAC's adjustment freeze would punish cost-efficient facilities. "It's a backward way of looking at cost savings and payments."
Mr. Romansky argues that industry growth and revenue statistics are not a proxy for ASC profitability or the need for an inflation adjustment; that facilities should be rewarded, not penalized, for their efficiency and productivity; and that these payment issues should be addressed in a comprehensive manner after the new ASC payment system has been fully phased in, not in the midst of its transition.
Daniel Cook | 
As part of the Joint Commission's Standards Improvement Initiative, accreditation manuals for ASCs, office-based surgery facilities and hospitals are now available in electronic format through Joint Commission Resources, the commission's not-for-profit educational affiliate.
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