The gradual shift from inpatient to outpatient care has given patients increased flexibility in their medical care. By seeking treatment at ambulatory surgery centers (ASCs), outpatients will not only avoid overnight hospital stays, but also benefit from more cost-effective and transparent pricing models, as well as a more intimate treatment setting compared to that in hospital departments. Due to their increased efficiency, potential cost savings, and operational effectiveness, ASCs represent a pragmatic and evolutionary shift for patients, taxpayers, and physicians alike.
An ASC is defined as a healthcare facility where surgical care is delivered to patients without a hospital admission. On the other hand, hospital outpatient departments (HOPDs) are OR suites within hospitals that are designed to serve non-overnight patients [6]. Both care settings comprise the growing sector of outpatient surgical care. The last decade has seen a 6.6% decrease in inpatient stays, despite the population boom from 2005 to 2015; on the other hand, visits to outpatient facilities have increased by 14% [1,8]. Although both forms of delivery currently benefit from the shift to outpatient care, ASCs have several attractive distinctions compared to traditional hospital outpatient surgery departments.
The first example of the ASC advantage lies in efficiency. According to the Ambulatory Surgery Association, Medicare spends roughly 82% more for the same procedures performed in hospital outpatient departments as compared to those performed in ASC’s [2]. Moreover, after adjusting for procedure type, patients spend on average 31.8 minutes less under surgery in ASCs than in HOPDs [9]. With such noteworthy differences in pricing and surgical efficiency, ASCs improve the ability of patients to afford treatment; allows doctors to effectively utilize their time; and saves taxpayers money.
The second key distinction of ASCs lies in their unmatched history of personalized care. As early as 2006, 70 percent of ASC’s had no more than twenty employees on staff [4]. Although typically smaller in scale than HOPDs, ASCs are better able to specialize [4,10]. Because of this specialization, ASC physicians can tailor their services to patient needs. Therefore, ASC physicians can give a level of individualized care logistically unmatchable in hospital settings. This phenomenon has helped lead to a 22% higher satisfaction rate among patients treated in ASCs versus hospital outpatient surgical departments [10].
ASCs’ third merit is that compared to HOPDs, they are more willing to disclosure service prices [2]. In a study by Ge Bai et al., ASCs’ throughout several states quoted a single bundled price for procedures prior to operation [5]. The demand for this transparency is reflected by new White House policy measures forcing healthcare providers to be more up front about costs for routine procedures [7]. In a digital age where transparency is highly valued in professional, academic, and digital settings, the desire for the same level of consciousness from the medical industry makes many ASCs policy front runners. In conjunction with government policy, such practices will likely encourage transparency throughout the medical industry and decrease the frequency of patients being blind-sided by excessive hospital rates.
It is no secret that patients and taxpayers would prefer to not foot the bill of bloated healthcare expenditures. In addition, many physicians desire the freedom to better specialize and optimize their time management in the process. Luckily, the growing prominence of ASCs allows these preferences to be conveniently met. ASC growth has been a positive trend and will set the stage for the continued evolution of quality and cost-effective patient care.
References
1. AHA Annual Survey Database, ahadata.com. Accessed July 4, 2019.
2. Ambulatory Surgery Center Association. Ascassociation.org. Accessed July 4, 2019. https://www.ascassociation.org/advancingsurgicalcare/aboutascs/industryoverview/apositivetrendinhealthcare.
3. University of South Florida. “Ambulatory and Primary Care.” USF.edu. Accessed July 4, 2019. http://eta.health.usf.edu/publichealth/HSC4933US/wk6/AmbulatoryPrimaryCare.pdf.
4. Ambulatory Surgery Center Association. “Ambulatory Surgery Centers Brochure.” Inova.org. Accessed July 4, 2019. https://www.inova.org/upload/docs/Healthcare Services/Surgery/ambulatory-surgery-centers-brochure.pdf,.
5. Bai, Ge, Pavan Patel, Martin A. Makary, and David A. Hyman. “Providing Useful Hospital Pricing Information To Patients: Lessons From Voluntary Price Disclosure.” Healthaffairs.org. April 19, 2019. Accessed July 4, 2019. https://www.healthaffairs.org/do/10.1377/hblog20190416.853636/full/.
6. The Free Dictionary. 2012. Accessed July 4, 2019. http://medical-dictionary.thefreedictionary.com/Outpatient department.
7. The White House. “Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First.” The White House. June 24, 2019. Accessed July 4, 2019. https://www.whitehouse.gov/presidential-actions/executive-order-improving-price-quality-transparency-american-healthcare-put-patients-first/.
8. Deloitte Insights. “Growth in Outpatient Care, The Role of Quality and Value Incentives.” Www2.deloitte.com. 2018. Accessed July 4, 2019. https://www2.deloitte.com/content/dam/insights/us/articles/4170_Outpatient-growth-patterns/DI_Patterns-of-outpatient-growth.pdf.
9. Munnich, Elizabeth L., and Stephen T. Parente. “Procedures Take Less Time At Ambulatory Surgery Centers, Keeping Costs Down And Ability To Meet Demand Up.” Healthaffairs.org. May 2014. Accessed July 4, 2019. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2013.1281.
10. West Plains Surgery Center. “Why Choose West Plains Surgery Center over a Hospital?” Www.wpsurgerycenter.com. 2019. Accessed July 4, 2019. http://www.wpsurgerycenter.com/why-choose-west-plains-surgery-center-over-a-hospital.
