Study Finds Ambulatory Surgery Centers (ASCs) Reduce Out-of-Pocket Costs for Patients with Private Health Insurance

Patients Urged to Shop, Compare Prices Before Having Procedures

OMAHA, NE (August 10, 2016) - An analysis of private health insurance claims from across the country found ambulatory surgery centers (ASCs) reduce the cost of outpatient surgery by more than $38 billion dollars per year by providing a lower cost site of care compared to hospital outpatient departments (HOPDs).  The research concluded that ASC prices are significantly lower than HOPD prices for the same procedures, throughout the country, regardless of market.

The study also found that $5 billion of the annual savings were reduced out-of-pocket costs for ASC patients realized through lower deductible and coinsurance payments.  Depending upon the procedure and health insurance plan, the study found patients could be saving $1,000 or more in out-of-pocket costs by choosing the ASC setting.

In Charlotte, North Carolina, for example, the researchers found that knee arthroscopy patients who have a Silver Plan from the exchanges would save $1,275 in out-of-pocket costs for that procedure by choosing an ASC over an HOPD.  Bronze plan members would likely save more since they usually have higher coinsurance and maximum out-of-pocket rates.

Maggie Summerfelt, Advanced Surgery Center Administrator said, “The physicians and nurses providing care in ambulatory surgery centers, as well as the millions of patients they have treated, have long known that ASCs provide a high-quality, low-cost alternative to hospitals for outpatient procedures.  This study is solid evidence that consumers need to shop and compare out-of-pocket costs for all outpatient procedures.”

The recent study was conducted by Healthcare Bluebook ™, a national provider of quality and cost data for healthcare services in partnership with HealthSmart, the nation’s largest independent administrator of health plans for self‐funded employers.  The Ambulatory Surgery Center Association (ASCA), representing the interests of more than 5,400 outpatient surgery centers, contributed technical assistance and expertise to the report.

Read the private health insurance study here: www.advancingsurgicalcare.com/hcbbstudy.

A 2014 study by researchers at the University of California at Berkeley (available at www.advancingsurgicalcare.com/Berkeleystudy) concluded that ASCs also provide significant savings to Medicare beneficiaries.