title: Growth of ambulatory surgical centers, surgery volume, and savings to medicare.
abstract: We studied the impact of the growth of ambulatory surgical centers (ASCs) on total Medicare procedure volume and ASC market share from 2000 to 2009 for four common outpatient procedures: cataract surgery, upper gastrointestinal procedures, colonoscopy, and arthroscopy. ASC growth was not significantly associated with Medicare volume, except for colonoscopy. An additional ASC operating room per 100,000 population results in a 1.8% increase in colonoscopies performed in all outpatient settings. Increases in the number of ASCs were associated with greater ASC market share with effects ranging from 4- to 6-percentage-point gains for each additional ASC operating room per 100,000. The study demonstrates that continued growth of ASCs could reduce Medicare spending, because ASCs are paid a fraction of the amount paid to hospital outpatient departments for the same services.
authors.affiliation: KNG Health Consulting LLC, Rockville, MD 20850, USA. lane.koenig@knghealth.com
authors.forename: Lane
authors.initials: L
authors.lastname: Koenig
authors.forename: Qian
authors.initials: Q
authors.lastname: Gu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D017046:Cost Savings / Q000706:statistics & numerical data / Q000639:trends*; D018588:Fee-for-Service Plans; D005260:Female; D019981:Health Care Sector / Q000191:economics / Q000639:trends; D005102:Health Expenditures / Q000706:statistics & numerical data / Q000639:trends*; D006302:Health Services Research; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics* / Q000639:trends; D018803:Models, Economic; D015999:Multivariate Analysis; D018584:Physician Self-Referral; D012044:Regression Analysis; D013531:Surgicenters / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D014481:United States