Ambulatory Surgery Centers and Prices in Hospital Outpatient Departments

Med Care Res Rev. 2017 Apr;74(2):236-248. doi: 10.1177/1077558716633010. Epub 2016 Aug 3.

Abstract

Specialty providers claim to offer a new competitive benchmark for efficient delivery of health care. This article explores this view by examining evidence for price competition between ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). I studied the impact of ASC market presence on actual prices paid to HOPDs during 2007-2010 for four common surgical procedures that were performed in both provider types. For the procedures examined, HOPDs received payments from commercial insurers in the range of 3.25% to 5.15% lower for each additional ASC per 100,000 persons in a market. HOPDs may have less negotiating leverage with commercial insurers on price in markets with high ASC market penetration, resulting in relatively lower prices.

Keywords: hospitals; prices; surgery centers.

MeSH terms

  • Ambulatory Care Facilities / economics
  • Ambulatory Care Facilities / statistics & numerical data*
  • Ambulatory Surgical Procedures / economics
  • Ambulatory Surgical Procedures / statistics & numerical data
  • Costs and Cost Analysis / economics*
  • Economic Competition / economics*
  • Humans
  • Insurance Claim Review / statistics & numerical data
  • Outpatient Clinics, Hospital / economics
  • Outpatient Clinics, Hospital / statistics & numerical data*
  • Outpatients