Ambulatory surgical center services
For patients needing surgery that doesn't require an overnight stay, payment for services and access is adequate, the commission said, recommending a smaller .5% payment increase.
However facility growth slowed to 1.9% in 2010 and volume growth slowed to 1.6%, perhaps reflecting the sluggish economy and the fact that Medicare payments are 74% higher in OPDs, a "payment gap (that) may have influenced some ASC owners to sell their facilities to hospitals."
ASCs should have to submit data on quality care, as they are scheduled to do as of October, 2012. And ASCs should also have to submit data on the cost of services they provide to Medicare beneficiaries.
Outpatient dialysis services
The commission recommends a 1% increase in payment for dialysis services for 355,000 end stage renal disease Medicare beneficiaries.
The payment structure underwent a major change in 2011, when Medicare stopped paying separately for erythropoiesis-stimulating agents, "a drug class accounting for three-fourths of dialysis drug spending," the report said. "This decline is linked to clinical evidence showing that higher use of these drugs is associated iwth increased risk of cardiovascular events.
"It also may be linked to facilities' and physicians' modifying their prescribing patterns in anticipation of the new payment method...that no longer pays separately for these drugs."