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Study reveals little variation between costs of services in different outpatient settings

Ambulatory Surgery Reimbursement Update, November 7, 2006

A new study reveals little difference between the cost and quality of three different procedures when performed at hospital outpatient departments (OPDs), ambulatory surgery centers (ASCs) and doctor's offices, according to a report from Medicare Payment Advisory Committee (MedPAC).

The study, commissioned by MedPAC and conducted by RAND Health, examined whether the type of setting affected the characteristics of the patients and therefore the cost of the procedures, and whether the setting affected the rates of adverse outcomes following the procedures.

The procedures studied were colonoscopies, cataract surgery, and magnetic resonance imaging (MRI) of the head and neck.

The study reached the following conclusions:

• "Rates of most patient characteristics that might increase the cost of performing one of the three services were very low in all settings; the vast majority of characteristics were present in fewer than 10% of patients.
• "Looking across all three services and settings, no single setting had consistently higher rates of characteristics that might increase the cost of the procedure. Where two statistical differences existed, OPD patients had higher rates of characteristics than ASC patients for cataract surgery and colonoscopy, but patients treated in physician offices and testing facilities had higher rates of certain characteristics for MRI of the head, neck, and brain.
• "Rates of adverse outcomes were very low in all settings, and the magnitude of significant differences among settings was quite small."

To view MedPAC's report, click here.

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