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• W2049851288 abstract "No AccessJournal of UrologyAdult Urology1 Sep 2008Medicare Reimbursement Changes for Ambulatory Surgery Centers and Remuneration to Urological Physician-Owners Seth A. Strope, Stephanie Daignault, John M. Hollingsworth, John T. Wei, and Brent K. Hollenbeck Seth A. StropeSeth A. Strope More articles by this author , Stephanie DaignaultStephanie Daignault More articles by this author , John M. HollingsworthJohn M. Hollingsworth More articles by this author , John T. WeiJohn T. Wei More articles by this author , and Brent K. HollenbeckBrent K. Hollenbeck More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2008.05.051AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To decrease the cost of surgical care Medicare has introduced a new facility fee schedule for ambulatory surgical centers. This prospective payment system increases reimbursement for many urological procedures, while decreasing reimbursement for others. All stakeholders, including physicians, the Medicare program and hospitals, will be affected by these changes. Materials and Methods: Using the Agency for Healthcare Research and Quality State Ambulatory Surgery Databases we identified Medicare patients in Florida who underwent urological procedures in ambulatory surgical centers from 1998 to 2005. Three facility groupings were created, including urology dominant, multispecialty and other specialty dominant. The impact of reimbursement changes at the procedure and facility levels was assessed using 2005 data. Projections of ambulatory surgical center use and reimbursement in 2008 were then generated using all available data. Results: In 2008 we project total payments by Medicare to increase by $4,233,080 (26%, range 22% to 32%) under the new reimbursement system compared to the old system. At the facility level reimbursement to multispecialty facilities should increase substantially (49%), while urology specialty facilities will receive less benefit (10% increase). Compared to multispecialty facilities, at urology specialty facilities a higher proportion of cases is performed for which reimbursement is set to decrease. Conclusions: Under the new payment scheme for ambulatory surgical centers winners and losers emerge. Facilities with diversified procedure mixes will find increased revenue, while those with less diversification will find slower growth to their revenue streams. In contrast to the desire of the Medicare program to decrease surgical costs, the new program may increase the payments made for urological surgery. References 1 : High and rising health care costs. Part 1: seeking an explanation. Ann Intern Med2005; 142: 847. Google Scholar 2 : Ambulatory surgery centers—current business and legal issues. J Health Care Fin2000; 27: 1. Google Scholar 3 If You're Niched, It Might Be Your Fault: Physician-Driven Specialty Hospitals and Ambulatory Surgery Centers. In: . New York: Cain Brothers2003: 1. Google Scholar 4 Medicare program; ambulatory surgical services—Health Care Financing Administration: Final rule. Fed Regist1982; 47: 34082. Google Scholar 5 : The effect of physician-owned surgicenters on hospital outpatient surgery. Health Aff2002; 21: 215. Google Scholar 6 : Prospective payment: Some retrospective observations. N Engl J Med1988; 318: 1681. Google Scholar 7 : Changing patterns of surgical care in the United States, 1980–1995. Health Care Financ Rev1999; 21: 31. Google Scholar 8 Medicare program; revised payment system policies for services furnished in ambulatory surgical centers (ASCs) beginning in CY 2008: Final rule. Fed Regist2007; 72: 42469. Google Scholar 9 Payment for procedures in outpatient departments and ambulatory surgical centers. OIG. OIG Rep 2003; OEI-05-00-00340: i, 2003. Google Scholar 10 Introduction to the HCUP State Ambulatory Surgery Database (SASD). Rockville: Agency for Healthcare Research and Quality2007. Google Scholar 11 : CPT 2007. Chicago: American Medical Association2006. Google Scholar 12 . College Park: Centers for Medicare and Medicaid Services, National Archives and Records Administration2004: 730. Google Scholar 13 : Specialty versus community hospitals: what role for the law?. Health Aff (Millwood), suppl.2005; . W5. Google Scholar Department of Urology, Division of Health Services Research, University of Michigan Health System, Ann Arbor, Michigan© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byFrendl D, Chen Y, Chang D and Kim M (2020) A Claims Based Assessment of Reoperation and Acute Urinary Retention after Ambulatory Transurethral Surgery for Benign Prostatic HyperplasiaJournal of Urology, VOL. 205, NO. 2, (532-538), Online publication date: 1-Feb-2021.Griebling T (2015) Re: Ambulatory Surgery Centers and Outpatient Urologic Surgery among Medicare BeneficiariesJournal of Urology, VOL. 193, NO. 6, (2058-2059), Online publication date: 1-Jun-2015.Penson D (2014) Re: Procedures Take Less Time at Ambulatory Surgery Centers, Keeping Costs Down and Ability to Meet Demand UpJournal of Urology, VOL. 193, NO. 1, (257-259), Online publication date: 1-Jan-2015.Hampson L and Montie J (2012) Conflict of Interest in UrologyJournal of Urology, VOL. 187, NO. 6, (1971-1977), Online publication date: 1-Jun-2012.Tan H, Strope S, He C, Roberts W, Faerber G and Wolf J (2011) Immediate Unplanned Hospital Admission After Outpatient Ureteroscopy for Stone DiseaseJournal of Urology, VOL. 185, NO. 6, (2181-2185), Online publication date: 1-Jun-2011.Strope S, Wolf J, Faerber G, Roberts W and Hollenbeck B (2009) Changing Practice Locations for Upper Urinary Tract Stone DiseaseJournal of Urology, VOL. 182, NO. 3, (1005-1011), Online publication date: 1-Sep-2009. Volume 180Issue 3September 2008Page: 1070-1074 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsambulatory surgical proceduresincentiveMedicareurologyownershipreimbursementMetricsAuthor Information Seth A. Strope More articles by this author Stephanie Daignault More articles by this author John M. Hollingsworth More articles by this author John T. Wei More articles by this author Brent K. Hollenbeck More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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