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Number of Medicare-certified ambulatory surgery centers (ASCs)

  • 4,798  2007
  • 5,001  2008
  • 5,111   2009
  • 5,203  2010
  • 5,291  2011
  • 5,357  2012
  • 5,377  2013 (3rd quarter)

Over the period 2007 to 2012, the number of Medicare-certified ASCs grew by 12 percent overall, but a higher annual growth rate was seen in 2007 and 2008 than in more recent years, during which the growth rate has fallen to well under 2 percent per year.  MedPAC speculates that this may be due to many factors, including the economy, a major revision of the ASC payment system in 2008, saturation of the market, and an increased trend toward physician employment by hospitals.

Number of Operating Rooms in ASCs?  MedPAC reports average of 2.8 and a median of 2 ORs/ASC.  Last year, I called and found that MedPAC does not have the total count of ORs.  The analyst suggested multiplying the average by the total number of facilities.  So, here we go:

  • 5,377 ASCs in 3rd Quarter 2013 x 2.8 average ORs/facility =15,056 total ORs in ASCs.  But, since we’re estimating anyway, let’s round it to about 15,000  total ASC operating rooms currently in the US.

Procedures migrating from hospital outpatient setting to ASCs?  Trend has stalled.

Top types of procedures done in ASCs?  These make up about 50% of procedures (I believe this analysis is for Medicare beneficiaries only):

  1. Cataract with intraocular lens insert, 1 stage (this is the top procedure by a wide margin — 20 percent of volume)
  2. Upper GI endoscopy, biopsy
  3. Diagnostic colonoscopy
  4. Colonoscopy with biopsy
  5. After cataract laser surgery
  6. Lesion removal colonoscopy
  7. Injection spine: lumbar, sacral (caudal)

Source:  Ambulatory surgical center services, in: Medicare Payment Policy: Report to the Congress.  Washington, DC: MedPAC, 2014, Chapt. 5, pp 121-138.  Click here for full text free:  http://medpac.gov/documents/Mar14_EntireReport.pdf    Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

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