UnitedHealth report: Shifting common outpatient procedures to ASCs could yield significant savings

Conducting common surgical procedures in ambulatory surgical centers can lead to significant savings for patients and payers, according to a new analysis from UnitedHealth Group researchers.

The report finds that shifting outpatient procedures for non-complex, commercially insured people could reduce spending on these services by 59%. The average price for these procedures in the hospital was 144% higher than the price in ASCs, according to the report.

Common outpatient procedures in the hospital cost $7,716 on average compared to $3,157 on average in ASCs. That's a gap of $4,559, the report found.

Lambert van der Walde, senior vice president and executive director of the Center for Health Care Research at UnitedHealth Group, told Fierce Healthcare that health plans can—and should—be doing more to empower patients to seek care at alternative sites when possible.

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"We’re eager to make sure that our members understand and ask the right questions as they navigate this complicated healthcare system," he said.

The report found that of the 10 million routine outpatient surgeries performed by hospital outpatient departments, just 10% are for people with complex comorbidities, such as morbid obesity or end-stage renal disease. In 35% of cases, the patient does not have an ASC near their home.

The remaining 56% of such procedures are among non-complex patients who live near an ASC, and could thus be shifted to that site of care to lower costs, according to analysis.

As commercially insured patients themselves bear about 15% of the costs of these procedures, this would lead to savings of $684 per procedure on average.

"It’s an opportunity to save members money and make sure these procedures are done in a high-quality setting," said van der Walde.