Greed is good, but what's going on in Illinois is ridiculous. Blue Cross Blue Shield of Illinois has informed the state's 120 outpatient surgery centers that it will terminate their provider agreements unless they agree to the take-it-or-leave-it terms of an amended policy.

No more carveouts.
Payments will be capped at 50 percent to 60 percent of covered charges, not to exceed an all-inclusive rate of $1,200 to $1,400 per case.

Days after this story broke, we learned that the nation's Blue Cross Blue Shield plans saw their combined profits jump 63 percent last year, to $5.4 billion from $3.3 billion in 2002. Nice.

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Ambulatory surgery centers: Patients love them. Doctors love them. Hospitals hate them.

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Do partial victories count in the standings? If so, score one for ASCs and one for hospitals.

In South Carolina, state regulators have backed off a proposed year-long ban on new outpatient surgery centers. They want to replace the moratorium with new standards that would ostensibly slow the pace of new construction. The number of ASCs in South Carolina has exploded in recent years, from 22 in 1999 to 57 today, with many more approved but not yet up and running.

In Washington, D.C., the American Hospital Association has already drummed up support for a permanent ban on specialty hospitals - even though we're only halfway through the 18-month federal moratorium on physician-owned specialty hospitals. According to reports, the AHA has already corralled support from several lawmakers who want Congress to consider extending the moratorium past its scheduled expiration of May 7, perhaps making it permanent.

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More is lost by indecision than by wrong decision, which is another way of saying that it's better to ask for forgiveness than for permission.

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We were humbled and honored by the results of an an independent readership study that showed managers of surgical facilities in hospitals, ambulatory surgery centers and office-based surgery centers read Outpatient Surgery Magazine far more frequently and more thoroughly than any other publication. In just four years, Outpatient Surgery has become the best- circulated, best-read publication among managers of all surgical facilities. As always, we thank you for reading, for caring and for sharing.