Managed Care

 

More outpatient surgeries taking place

MANAGED CARE March 2010. © MediMedia USA
News and Commentary

More outpatient surgeries taking place

MANAGED CARE March 2010. ©MediMedia USA

Nearly 60 percent of all surgical procedures take place in an ambulatory setting, where the patient receives less than 24 hours of hospital care, according to a recent report from the Agency for Healthcare Research and Quality (AHRQ). That’s good news to health plans, considering that the mean charge for ambulatory surgery is lower than for inpatient surgery — $6,100 versus $39,900. (Bold intended!) The study collected data from 28 states.

There are two factors that might explain the overall growth in ambulatory surgeries. First, surgery has become easier with advances in surgical technology and anesthesia. Second, health care payment policies encourage ambulatory surgery. For example, Medicare adopted an outpatient payment system authorizing payment for surgical services in a variety of settings, such as a physician’s office, a hospital outpatient department, or an ambulatory surgical center.

Characteristics of outpatient and inpatient surgeries
Characteristics Ambulatory surgeries Inpatient surgeries
Total visits/stays for surgeries (percentage of all surgical encounters) 10.8 million (57.7%) 7.9 million (42.3%)
Visits/stays per 100,000 population 5,600 4,100
Total number of surgeries (percentage of all surgical procedures) 12.4 million (53.0%) 11.0 million (47.0%)
Average number of surgeries per visit/stay 1.2 1.4
Total charge (percentage of total charges for surgical encounters) $55.6 billion (17.7%) $289.9 billion (82.3%)
Mean charge per visit/day $6,100 $39,900
Source: Agency for Healthcare Research and Quality. Statistical Brief #86, February 2010.

Meetings

4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015