Medicare payment rates for ambulatory surgery centers will increase by 0.2% across the board next year according to the 2011 final payment rule for ASCs and hospital outpatient departments announced yesterday.

The Centers for Medicare and Medicaid Services has changed its payment rate update from the 0% change proposed earlier this year to the slight 0.2% increase, which takes into account the 1.5% inflationary update offset by a -1.3% productivity adjustment mandated by the healthcare reform act passed last spring. HOPD rates will increase 2.35% in 2011, based on the 2.6% hospital market basket update and the .25% reduction mandated by the Affordable Care Act.

"We are pleased that ASCs will be seeing a slight improvement over the original proposal and continue to hope that, in the future, CMS will do more to bring parity to the [ASC and HOPD] payment systems," said ASC Association Board Chair David Shapiro, MD, CASC, in a statement. The ASC Association expressed disappointment that CMS did not heed the advice from industry leaders and members of Congress to "better align the ASC and HOPD payment systems to prevent the rates from drifting further apart in the coming years."

The 2011 final rule is the last step in the 4-year transition from the old "grouper" system to the revised ASC payment system initiated in 2008. The rule, which will be added to the federal register on Nov. 24 and opened for comment until Jan. 3, 2011, also implements several provisions of the Affordable Care Act, such as the ban on the development of new and expansion of existing physician-owned hospitals.

CMS declined to require quality reporting from ASCs in the final rule, but did expand the "set of quality measures that must be reported by HOPDs to qualify for the full annual payment update factor." The transition to the new measure set will take place over a 3-year period, according to CMS.

Irene Tsikitas

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