Competition from outpatient surgery centers heats up

The North Carolina Hospital Association is opposing state legislation that would make it easier for doctors to open outpatient surgery centers, the Charlotte Observer reported.

Republican supporters of N.C. House Bill 177 say the state's certificate-of-need (CON) program is too restrictive, making outpatient surgeries more expensive by overly restricting competition, the newspaper reports.

The state hospital association counters that the bill would "benefit a few doctors at the expense of hospitals," and won't lead to lower costs or state savings, according to the report.

According to the Observer, the bill would:

  • Lift restrictions in most counties on the number of single-specialty operating rooms in ambulatory surgery centers. The 23 counties with critical access hospitals would be exempted.
  • Require applicants to demonstrate they expect to perform at least 800 procedures per year, including indigent patients.
  • Exempt diagnostic centers from CON review for imaging equipment including CT scanners and X-ray machines.
  • Prohibit hospitals from relocating operating rooms from their main campuses to separate locations, which often charge facility fees.

In New York City, hospitals are worried same-day surgery centers will force them out of business, The New York Post reported. The city has 36 licensed ambulatory surgery centers that operate with smaller staff and overhead.

North Carolina has fewer than 100 ambulatory surgery centers, with the number of centers per capita far below the national average, the Observer noted.

Meanwhile, a study published last year in the journal Medical Care Research and Review found that care costs are slightly lower in states without CON regulations.

To learn more:
- read the Charlotte Observer article
- here's the New York Post report