AHRQ Study: Price Increases Steady for Ambulatory Surgery Centers, Significantly Higher for Hospital Outpatient Surgery Departments

Issue 494
AHRQ's Electronic Newsletter summarizes Agency research and programmatic activities.
November 10, 2015

AHRQ Stats: Causes of Death

Heart disease remained the leading cause of death in the United States, followed by cancer and chronic lower respiratory disease, in 2010. Cancer was the leading cause of death for adults age 45 to 64, while accidents were the leading cause of death for adults age 25 to 44. (Source: Agency for Healthcare Research and Quality, 2014 National Healthcare Quality and Disparities Report, Chartbook on Effective Treatment.)

Today's Headlines

  1. AHRQ Study: Price Increases Steady for Ambulatory Surgery Centers, Significantly Higher for Hospital Outpatient Surgery Departments.
  2. New Research and Evidence From AHRQ.
  3. AHRQ Study: Flu Vaccines in Nursing Homes Save Thousands of Lives Each Year.
  4. AHRQ Study: Alert System Helps Ensure Patients Get Radiology Test Results.
  5. Act Now: Registration, Session Proposals Now Being Accepted for TeamSTEPPS® National Conference.
  6. Featured Case Study: Texas Hospital Improves Discharges With AHRQ's RED Toolkit.
  7. AHRQ in the Professional Literature.

1. AHRQ Study: Price Increases Steady for Ambulatory Surgery Centers, Significantly Higher for Hospital Outpatient Surgery Departments

The proliferation of ambulatory surgery centers (ASCs) has not led to a decrease in hospital outpatient surgery department prices, according to a new AHRQ-funded study. ASCs are medical facilities where surgery that does not require hospital admission is performed. This study examined ASC growth and revenues using a large national claims database that contains information on actual prices paid. The author found that for six common outpatient surgical procedures—cataract surgery with intraocular lenses, colonoscopy, knee arthroscopy with debridement, knee arthroscopy with meniscectomy, postcataract surgery and upper gastrointestinal endoscopy—prices paid to ASCs remained stable during 2007–2012, while prices paid to hospital outpatient surgery departments (HOPSDs) for the same procedures increased sharply. The study also found that private insurers paid ASCs more than Medicare paid ASCs for the same procedures. Medicare currently pays ASCs a legislated percentage of what it pays HOPSDs for the same services, but there is a considerable discrepancy between this ratio and the ratio of payments by private insurers across provider types and procedures. These findings question the use of a single ratio for ASC payments to HOPSD payments and suggest that ASCs and HOPSDs do not currently compete on price. The findings support the argument for increased price transparency and narrow or tiered insurance network designs that reward high-value providers. The study, "Price Increases Were Much Lower In Ambulatory Surgery Centers Than Hospital Outpatient Departments In 2007-12," and abstract were published in the October issue of the journal Health Affairs.

2. New Research and Evidence From AHRQ

Key Lessons from the National Evaluation of the CHIPRA Quality Demonstration Grant Program

3. AHRQ Study: Flu Vaccines in Nursing Homes Save Thousands of Lives Each Year

Effective influenza vaccines in U.S. nursing homes save about 2,560 lives and prevent more than 3,200 hospitalizations annually, according to an AHRQ-funded study. Researchers studied more than 1 million Medicare fee-for-service, long-stay nursing home residents between 2000 and 2009. With well-matched vaccines, deaths dropped by an estimated 2 percent; pneumonia/influenza hospitalizations dropped 4.2 percent. Authors concluded influenza vaccination is an important strategy for preventing both flu and pneumonia in these elderly adults. The study, "Estimating the Effect of Influenza Vaccination on Nursing Home Residents' Morbidity and Mortality," appeared online August 17 in the Journal of the American Geriatrics Society. Read the abstract.

4. AHRQ Study: Alert System Helps Ensure Patients Get Radiology Test Results

An AHRQ-funded study found that an electronic alert notification system improved the frequency of notifications to patients about their radiology test results. Before the alerts, 19 percent of patients did not hear back from their doctors; afterward, just 5 percent weren’t notified. The researchers evaluated the impact of the patient safety initiative with an alert notification system to reduce the number of times doctors did not communicate critical radiology results to patients. Researchers also assessed potential overuse of the alerting system, finding evidence that the system did not notify physicians more often than necessary with noncritical results. Future studies are needed to evaluate whether such systems prevent subsequent patient harm, they concluded. "Impact of an Electronic Alert Notification System Embedded in Radiologists' Workflow on Closed Loop Communication of Critical Results: A Time Series Analysis," was published online September 15 in the journal BMJ Quality & Safety. Read the study abstract.

5. Act Now: Registration, Session Proposals Now Being Accepted for TeamSTEPPS® National Conference

Registration is open for the June 8–10, 2016, TeamSTEPPS National Conference in Washington, D.C. TeamSTEPPS, developed by AHRQ and the Department of Defense, is an evidence-based patient safety system that enhances teamwork skills among health care professionals. The TeamSTEPPS National Implementation Team is currently seeking proposals for concurrent breakout sessions and posters. The submission form and guidelines are due by November 13. There is no cost to attend the conference. Contact AHRQTeamSTEPPS@aha.org with questions.

6. Featured Case Study: Texas Hospital Improves Discharges With AHRQ's RED Toolkit

Nacogdoches Memorial Hospital, a 216-bed trauma center in Nacogdoches, Texas, saw 30-day all-cause readmissions drop from 18.6 percent to 16.6 percent in the six-month period after implementing AHRQ's Re-Engineered Discharge (RED) toolkit. The toolkit helped reduce the hospital’s readmission rate and built momentum among clinicians to improve the patient discharge process. Read the case study.

7. AHRQ in the Professional Literature

California’s early ACA expansion increased coverage and reduced out-of-pocket spending for low-income population. Golberstin E, Gonzales G, Sommers BD. Health Affairs 2015 Oct 1;34(10):1688-94. Select to access the abstract on PubMed®.

Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals? Waehrer G, Deb P, Decker SL. Econ Hum Biol 2015 Aug 29;19:170-83. Select to access the abstract on PubMed®.

Determinants of Medicare plan choices: are beneficiaries more influenced by premiums or benefits? Jacobs PD, Buntin MB. Am J Manag Care 2015 Jul;21(7):498-504. Select to access the abstract on PubMed®.

Unresolved pain interference among colorectal cancer survivors: implications for patient care and outcomes. Kenzik K, Pisu M, Johns SA, et al. Pain Med 2015 Jul;16 (7):1410-25. Epub 2015 Mar 20. Select to access the abstract on PubMed®.

To test or not to test ... decision analysis of decision support. Courtney DM, Mills AM, Marin JR. Acad Emerg Med 2015 May;22(5):594-6. Epub 2015 Apr 21. Select to access the abstract on PubMed®.

Factors associated with increased cesarean risk among African American women: evidence from California, 2010. Huesch M, Doctor JN. Am J Public Health 2015 May;105(5):956-62. Epub 2015 Mar 19. Select to access the abstract on PubMed®.

Barriers to calling 911 and learning and performing cardiopulmonary resuscitation for residents of primarily Latino, high-risk neighborhoods in Denver, Colorado. Sasson C, Haukoos JS, Ben-Youssef L, et al. Ann Emerg Med 2015 May;65(5):545-52.e2. Epub 2014 Dec 3. Select to access the abstract on PubMed®.

Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study. Abrahamson K, Miech E, Davila HW, et al. BMJ Qual Saf 2015 May; 24(5):311-7. Epub 2015 Mar 6. Select to access the abstract on PubMed®.

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Page last reviewed November 2015
Page originally created November 2015
Internet Citation: AHRQ Study: Price Increases Steady for Ambulatory Surgery Centers, Significantly Higher for Hospital Outpatient Surgery Departments. Content last reviewed November 2015. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/494.html