ASC Reimbursement Trends: On the Up and Up

Published in Becker’s ASC Review

For each of the past five years, VMG has distributed the Intellimarker: Ambulatory Surgical Center Financial & Operations Benchmarking Study (the “Intellimarker”) that compiles the financial and operational data for over 240 ASCs nationwide. A trend observed in the Intellimarker is an increase in median net revenue per case for ambulatory surgery centers for three of the last four years.

It’s common to hear several industry leaders discuss both commercial and government reimbursement cuts. Surprisingly, the charts above show that the median net revenue per case (across all specialties) has increased by approximately 6.0 percent compounded annually from $1,297 in 2007 to $1,639 in 2011.

Based on discussions with management companies and administrators, there are several plausible reasons for the increase in median net revenue per case. First, the uptick in reimbursement may be explained by procedure acuity. As physicians continue to perform lower acuity procedures in-office, the number of higher acuity procedures performed in ASCs has increased.

In addition to the shift of lower acuity procedures being performed in physician offices, some procedures historically reserved for inpatient venues are now being performed in outpatient settings. This is largely due to the development of technology and the increased acumen of physicians and support staff.

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