Hospital outpatients are sicker, poorer than ASC patients, study finds

Medicare patients who seek surgical care in hospital outpatient departments are more likely to have severe chronic conditions and be poorer than beneficiaries treated in ambulatory surgical centers, according to a study from the American Hospital Association.

KNG Health Consulting conducted the study on behalf of the AHA. Researchers analyzed claims data for Medicare fee-for-service beneficiaries who visited at least one HOPD or ASC for surgical care in 2017.

Researchers found Medicare beneficiaries treated in HOPDs were more likely to:

  • Be under age 65 (individuals with disabilities or certain chronic conditions) or over age 85
  • Reside in lower-income areas
  • Have more severe chronic conditions
  • Have previous hospitalizations
  • Be eligible for both Medicare and Medicaid
  • Have previously sought care in the emergency department and, therefore, have higher Medicare spending

The study's findings "underscore the unsoundness of compensating hospitals and health systems under Medicare the same amount as ASCs and other locations of care," AHA said in a press release.

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