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Payment Rates for Ambulatory Surgery Centers Are Higher Than Intended by HCFA

HRD-84-67 Published: Jul 12, 1984. Publicly Released: Jul 12, 1984.
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Highlights

GAO examined the methodology used by the Health Care Financing Administration (HCFA) for establishing the standard overhead amounts to be paid to ambulatory surgery centers (ASC) and compared the cost to Medicare for surgery performed in ambulatory versus inpatient settings.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Health Care Financing Administration The Administrator, HCFA, should recompute ASC payment rates to incorporate the cost-to-charge adjustment.
Closed – Implemented
HCFA established new payment rates on March 12, 1990.
Health Care Financing Administration The Administrator, HCFA, should obtain more complete and current data on ASC costs and develop payment rates from it.
Closed – Implemented
HCFA developed and distributed a data collection form to gather the data which were used to compute new payment rates that were effective on March 12, 1990.

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Topics

Comparative analysisCost analysisHealth care costsMedical services ratesPaymentsSurgeryMedicareOutpatient carePhysiciansHospitals