Acute care hospitals in Pennsylvania want Congress to examine ambulatory surgery centers as a target for reimbursement cuts or other revenue measures. The hospitals believe that a review by the "super committee" charged with balancing the budget will show that ASCs are cherry picking lucrative commercially insured patients and shirking care for lower-paying Medicare, Medicaid and indigent care.
"We are asking the super committee to understand that hospitals nationwide have a $155 billion in cuts in the foreseeable future already on the table," as part of the Affordable Care Act, said Michael P. Strazzella, senior vice president for Federal Relations & Political Development at the Hospital & Healthsystem Association of Pennsylvania.
"Those cuts include $9 billion in Pennsylvania alone. There needs to be some recognition that there are other people who can afford to take those kinds of cuts without impact the care they provide," he said.
A report last month by the Pennsylvania Health Care Cost Containment Council showed that there are 266 ASCs in the state, up from 72 one decade ago. The council reported that ASC total profit margins have exceeded 26% in each of the past three years, while acute care hospitals see margins averaged 5.2%. HAP says that is partly because Medicaid accounted for only 4.5% of ASC revenue in 2010, compared to 11.8% of general acute care outpatient revenue.
"The pressure on acute care hospitals is increasing because there is a larger demand on public and private payers. We are seeing more people lose their private insurance and move to Medicare and Medicaid, even as those payments have decreased," Strazzella told HealthLeaders Media.