Debating Ambulatory Surgery Centers

Medicare’s Diagnostic Related Group (DRG) classification system changed (again) recently.  My (basic) understanding of the change means better reimbursement for hospitals (specifically academic medical centers) and less reimbursement for ambulatory surgery centers (ASC).

ASCs have been criticized in the past for operating on the best cases (low complications, highly reimbursed procedures, some even call 911 if complications arise during surgery because they don’t have emergency capacity).  However, an argument on the efficiency impact can’t be ignored.  The learning impact for providers who operate on similar cases on a daily basis should raise quality, something we obviously need.  The majority of patients who receive services from ASCs do just fine.

Regardless of what actually was intended by the DRG change or what happens in the future, what are your thoughts on ASCs?  Is the service they provide a benefit to our health care system?  Are they taking business away from hospitals?  Do they force hospitals to be more efficient? (As always this gets a little more complicated than asking a few simple questions: I think some other issues are at work here like physician ownership and referral patterns.)