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JHC Oct 22

Page 26

TRENDS

BY DANIEL BEAIRD

Hospital-Based ASC Ownership Consumer-driven trends, value-based strategies and better physician relationships encourage transition to ASCs.

The healthcare sector has significantly consolidated in recent years. Large health

off-campus PBD payments to 70% of

systems have acquired smaller hospitals and the remaining hospitals have amassed exist-

the full OPPS rate.

ing outpatient facilities like urgent care, imaging locations and independent physician

The OPPS rule was ruled to be

practices as outpatient care has become more popular. This has limited inpatient days

invalid by a federal judge that same year,

and lowered hospital revenues, all while the healthcare sector tackles higher overhead

but the U.S. District Court of Appeals

and labor costs.

for the D.C. Circuit overturned the court’s ruling in 2020. The American Hospital Association (AHA) and the

Site-neutral payments

Association of American Medical

to continue. Healthcare staffs are encour-

CMS implemented the Outpatient

Colleges (AAMC) are opponents of the

aged to expand their abilities for a variety

Prospective Patient System (OPPS)

site-neutral payment policy, but the U.S.

of alternative care sites and reimbursement

rule in 2019, extending a site-neutral

Supreme Court declined to hear AHA’s

models are being restructured to meet the

payment policy to off-campus provider-

appeal of the U.S. District Court of

shift toward outpatient services.

based departments (PBDs). It reduced

Appeals decision in 2021.

The preference for outpatient care is set

24

October 2022 | The Journal of Healthcare Contracting


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