CMS proposal could decrease hospital revenue, hospital officials say
Orthopedic surgeons and ambulatory surgery centers (ASCs) are excited by a new proposal by the Centers for Medicare and Medicaid Services (CMS) to pay for joint replacement surgeries performed in an outpatient setting.
CMS announced in mid-July that it was considering making total knee and hip replacement surgeries eligible for Medicare payments at ASCs. The move pleases orthopedic surgeons and facility owners, as they expect that Medicare payments will drive more patients to their facilities.
Hospital executives, however, oppose the CMS move for full joint replacement Medicare payments. Hospital officials believe it will cut into their revenue and drive patients away from their joint replacement facilities – one of a hospital’s most lucrative services – to ASCs. Over the past few years, ASCs have been consistently luring patients away from hospitals.
Hospital executives are also wary of the quality of care at ASCs and outpatient hospital centers for joint replacement surgeries.
Hospital executives concerns are validated by experts’ review, who say that CMS payments for joint replacement will drive patients away from hospitals. The proposal, experts say, could also drive more private insurers away to pay for joint replacement surgeries at ASCs and outpatient centers.
Read more in Modern Healthcare
Read more about ASCs and joint replacement in Becker’s ASC Review
Read about growing tension between hospitals and ASCs in Modern Healthcare