Sending 50% of the urological procedures currently done in hospitals to ASCs and physician offices would save Medicare nearly $66 million a year, according to a study published in the Journal of Urology.
Researchers analyzed cost data for 22 procedures across the 3 settings, including costs for post-operative complications and unexpected hospitalizations within 30 days of the procedures, and found ASCs and physician offices less costly for all but 2 procedures. Eighty-eight percent of the procedures analyzed were performed in the non-hospital settings, and patients in ASCs and physician offices tended to be lower-risk than those in hospital settings.
Average total payments ranged from $200 for urethral dilation in a physician's office to $5,688 for shock-wave lithotripsy in the hospital. Urodynamic procedures were more than 33% less expensive in ASCs, and prostate biopsies were nearly 75% less so. Physician offices weren't significantly more cost-efficient sites of service compared with ASCs. "Facility payments tended to be the driver of payment differences," write the researchers.
"The Medicare program accounts for 19% of total national spending on personal health services, making it the single largest payer in the United States," says lead study author John M. Hollingsworth, MD, of the department of urology, Dow Division of Health Services Research and Center for Healthcare Outcomes and Policy, at the University of Michigan in Ann Arbor. "Therefore, with regard to healthcare financing, as Medicare goes, so goes the nation."
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