MEDICARE POSTS AMBULATORY SURGICAL CENTER TRANSPARENCY INFORMATION
IMPORTANT STEP TOWARD TRANSPARENCY IN HEALTH CARE COSTS AND QUALITY
To help consumers, providers, and payers make more informed health care decisions, the Centers for Medicare & Medicaid Services (CMS) is making available Medicare payment information for 61 procedures performed in Ambulatory Surgery Centers (ASCs). An ASC is an accredited, freestanding facility that operates exclusively for the purpose of providing surgical services to patients not requiring hospitalization.
President Bush recently directed that more data be made available to all Americans as part of the Administration’s commitment to make health care more affordable and accessible. Today’s announcement is the second set of geographically-based information made available; information on what Medicare pays for 41 procedures performed in an inpatient hospital setting was posted at the beginning of June.
“This new data builds on the President’s commitment to making more quality and price data available,” Secretary Leavitt said. “By posting data about federal health care programs like Medicare, we are putting in motion efforts that will give Americans the information they need to make informed health care decisions.”
The new information posted by CMS at http://www.cms.hhs.gov/HealthCareConInit/ will help patients undergoing surgical procedures select the most appropriate setting for the delivery of high quality, efficient care. The information will show “Commonly Performed Procedures in ASCs”, and will contain charge and Medicare payment data for ASC facility costs for a limited number of services administered in states and counties. The data is broken down at the county, state and national level. CMS is also concurrently releasing data on “Other Commonly Performed Procedures in ASCs”, which contains similar charge and payment data, but for facility costs related to services of high utilization.
“The new information on services performed in ASCs adds to the information that people can use to make better decisions on their care,” said CMS Administrator Mark B. McClellan, M.D., Ph.D. “In all areas of care -- hospitals, physicians, nursing homes, health plans, and prescription drugs -- we are supporting collaborative efforts that are providing unprecedented information to help people get the best quality care for the best price.”
The department is working closely with a number of national and local organizations toward the goal of developing more comprehensive and personalized information on quality and cost. Building on private sector quality measurement efforts, a new Medicare pilot project, to be conducted initially in six geographic areas, will produce comprehensive quality data that will help improve the quality of Medicare-covered services, and provide information to Medicare beneficiaries that will assist them in making more informed choices among their health care options.
The quality information produced under this Medicare pilot project will be based on services provided to Medicare beneficiaries, Medicaid beneficiaries, and individuals with private health insurance in Massachusetts , Indiana , Minnesota , Wisconsin , Arizona and California . In making this information available to Medicare beneficiaries, it will also be available to providers, other insurers, employers, and the public.
Another example is the quality measures on hospitals across the nation currently being reported to the public at www.HospitalCompare.hhs.gov, supported by the Hospital Quality Alliance. In addition to the 20 clinical quality measures available now, the hospital information will be expanded to include information on patient satisfaction and outcomes in the coming year. These and other quality alliances are taking further steps to increase the range of useful measures being reported to consumers, including measures of care efficiency, and to develop quality measures for continuity of care with the AQA and other partners.
“The steps we are taking to provide patients better information is part of a long-range vision that can transform our health care system and put value and quality at the center,” said AHRQ Director Carolyn M. Clancy, M.D.
CMS has proposed that, beginning in 2008, a more significant expansion of the approved list of procedures that can be safely performed in an ASC as part of its proposed revisions to the ASC payment system. Under the proposal, all surgical procedures, other than those that pose a significant safety risk or generally require an overnight stay, would be included in the approved list. The expanded list of ASC services combined with the improved payment accuracy under the revised payment system should encourage the selection of the most appropriate setting for the delivery of high quality, efficient care for patients undergoing surgical procedures.