• Menu
  • Skip to main content
  • Skip to secondary navigation
  • Skip to primary sidebar
  • Skip to footer

Before Header

  • About
  • Contact
  • Privacy
 
Paradigm

Amaxx Workers Comp Blog

Reduce Workers Compensation Costs By 20-50%

Header Right

  • Home
    • Training Center
  • Search
    • Free Resources & Solutions
    • Subscribe to Free Newsletter
    • Create Free Training Center Account
    • Enroll in On-Demand Courses
    • Activate WC Mastery Membership
    • Request Strategic Coaching Session
    • Buy WC Guidebooks
  • Membership
    • Insider (free account)
    • WC Mastery
    • Teams & Managers Mastery
    • Training Partners
  • Products
    • On-Demand Courses
    • Specialty Courses
    • Certifications & Mastery Courses
    • Ultimate Guidebooks
    • Coaching
  • Blog
    • Video Blogs
    • COVID-19 / Coronavirus Pandemic
  • Login

Mobile Menu

  • Home
    • Training Center
  • Search
    • Free Resources & Solutions
    • Subscribe to Free Newsletter
    • Create Free Training Center Account
    • Enroll in On-Demand Courses
    • Activate WC Mastery Membership
    • Request Strategic Coaching Session
    • Buy WC Guidebooks
  • Membership
    • Insider (free account)
    • WC Mastery
    • Teams & Managers Mastery
    • Training Partners
  • Products
    • On-Demand Courses
    • Specialty Courses
    • Certifications & Mastery Courses
    • Ultimate Guidebooks
    • Coaching
  • Blog
    • Video Blogs
    • COVID-19 / Coronavirus Pandemic
  • Login
  • About
  • Contact
  • Privacy
You are here: Home / Medical & Pharmacy Management / Ambulatory Surgery Centers vs. Hospital Outpatient Departments. Which Is Better?

Ambulatory Surgery Centers vs. Hospital Outpatient Departments. Which Is Better?

June 30, 2020 By //  by Michael B. Stack

Members of the claim management team need to look for solutions to the rising cost of health care in workers’ compensation claim. As various medical facilities diversify, it should be an important consideration to look at providing quality health care to injured workers via ambulatory surgery centers. These centers can provide the same care as outpatient facilities in hospitals, but at a lower cost, and better service.

What is an Ambulatory Surgery Center?

Ambulatory surgery centers specialize in providing various healthcare services one would normally receive at a hospital, but often at a reduced cost. These services can include the following:

  • Surgical procedures: Primarily surgeries that involve bones, joints, and soft tissue. Common surgeries involve the knee, shoulder, and elbow;
  • Pain management treatment: Common procedures include injections, TENS united, exercise interventions, physical medicine, and rehabilitation; and
  • Diagnostic services: These include EMGs, MRIs, and CT scans. X-rays can also be performed.
    Click Link to Access Free PDF Download

    “The 6-Step Process To Determine Workers’ Comp Injury Causation”

They are not connected to a hospital, but used by surgeons to provide less complicated procedures that often do not result in an overnight stay. These centers are often known for providing better care at lower costs. They often are driven by the fact they do not require staffing for the variety of services a hospital will offer, which reduces the need for costly administrative and regulatory oversight. Although not connected to a hospital, they have access to lifesaving technology in case problems arise.

Driving Costs Savings Through Research

Claim handlers should do their research before directing injured employees to ambulatory surgery centers. This can result in cost savings in certain circumstances. A 2018 study by the Workers’ Compensation Research Institute (WCRI) entitled, Payments to Ambulatory Surgery Centers, highlights the effectiveness of these facilities. Examples of this include:

  • Knee arthroscopy procedures saved workers’ compensation programs as much as $2,000 per procedures;
  • Shoulder arthroscopy surgeries were about $3,000 less in the states of Pennsylvania, New York, and Michigan; and
  • A savings of roughly 45% when shoulder rotator cuff surgeries were undertaken at ambulatory surgery centers, when compared to outpatient healthcare facilities.

The study noted that various factors were attributed to the savings when an ambulatory surgery center. This included state workers’ compensation medical fee schedules, network participation rates, or other price controls that were negotiated in advance. It is also worth noting the study was not all inclusive, but did sample 23 states. The jurisdictions survey covered more than 66% of all workers’ compensation benefits paid in the years involved in the study.

In a related study, Comparing Payments to Ambulatory Surgery Centers and Hospital Outpatient Departments, the WRCI reviewed data from California, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin. These states were selected given their geographic locations, overall workforce sizes, and various pricing schemes within the programs. While ambulatory surgery centers were not cost effective in all jurisdictions and types of procedures, the study did indicate these centers generally provide services at a lower cost than those same services performed in a hospital outpatient setting.

“While ambulatory surgery centers were not cost effective in all jurisdictions and types of procedures, the study did indicate these centers generally provide services at a lower cost than those same services performed in a hospital outpatient setting.”

FREE DOWNLOAD: “The 6-Step Process To Determine Workers’ Comp Injury Causation”

Concern was expressed by some as a result of these studies that ambulatory surgery centers could not continue to provide quality services at lower costs for the long term. The result has been the implementation of fee schedules that are specifically helpful to the centers and allow for them to increase their billing rates. One such instances is Minnesota, which implemented a more favorable payment framework in October 2018. Notwithstanding this change, ambulatory surgery centers continue to be a viable option for members of the claim management team who seek to direct injured employees to quality healthcare facilities with the cost as one consideration.

Conclusions

Ambulatory surgery centers are able to provide specialized services to a growing segment of injured employees. These are the same services one could receive at an outpatient hospital program, but at a reduced cost to the workers’ compensation insurance carrier. Claim handlers should explore these options as they seek to reduce overall program costs.

Michael Stack - Amaxx Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center , which offers the Certified Master of Workers’ Compensation national designation.

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2020 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

FREE DOWNLOAD: “The 6-Step Process To Determine Workers’ Comp Injury Causation”

Filed Under: Medical & Pharmacy Management

Related Articles

Field Nurse Case Manager

Reducing Work Comp Costs With Field Nurse Case Managers

Reducing Work Comp Costs With Field Nurse Case Managers

Unnecessary IMEs Cost Your Program Money

Unnecessary IMEs Cost Your Program Money
Prescription Drug Abuse

Opioid Study Highlights Effective Use and Dangers

Opioid Study Highlights Effective Use and Dangers

Tools to Combating Pharmacy Spend in Workers’ Compensation

Tools to Combating Pharmacy Spend in Workers’ Compensation

Direct Healthcare to Reduce Work Comp Costs

Direct Healthcare to Reduce Work Comp Costs

Paradigm Appoints Chris Pricco as CEO of Specialty Networks

Paradigm Appoints Chris Pricco as CEO of Specialty Networks
Leverage Specialty Pharmacy Services in Complex Workers’ Comp Claims

Using Prescription Drug Formularies to Manage Work Comp Costs

Using Prescription Drug Formularies to Manage Work Comp Costs

Is Coronavirus Compensable in Workers’ Compensation?

Is Coronavirus Compensable in Workers’ Compensation?

Prescription Drug Formularies to Reduce Workers’ Comp Costs

Prescription Drug Formularies to Reduce Workers’ Comp Costs

Defending Medical Marijuana Claims

Defending Medical Marijuana Claims

What is Medical Cannabis?

What is Medical Cannabis?

7 Ways Organizations Can Mitigate Opioid-Related Problems

7 Ways Organizations Can Mitigate Opioid-Related Problems

Train to Succeed

BECOME CERTIFIED IN WORKERS’ COMPENSATION

Proven Course Catalog & WC Toolbox Give You The Power To Achieve Lower Costs and Better Injured Worker Outcomes

VISIT WORKERS' COMP TRAINING CENTER

Free Download

The 6-Step Process To Determine Workers' Comp Injury Causation - FREE Download Click Here Now!

Previous Post: «return to work 5 Best Practices to Get Injured Workers Back to Function — and Work
Next Post: Case Study: $101,312 Savings Through MSA Amended Review Process Reduce your workers' comp case study »

Primary Sidebar

FREE DOWNLOAD

The 6-Step Process To Determine Workers' Comp Injury Causation - FREE Download Click Here Now!

Our Sponsors

Catastrophic and Risk Solutions, Case Management Solutions, and Specialty Networks
 

Medcor

Injury Triage, Onsite Clinics
 

ARCADIA - Enhancing Settlement Outcomes

The Structured Settlements Company
 

MSAs, Section 111 Audits, & Conditional Payment Resolutions

Post-Settlement Administration

Read Our Award-Winning Blog

Blog Categories

Search Our Archive

Subscribe to Our FREE Newsletter

Return-to-Work Essentials

Footer

Search Our Archive

Search our continually growing archive of over 2500 articles about Workers' Comp issues.

Quiclinks

  • Calculators
  • Terms & Abbreviations
  • Glossary of WC Premium Terms
  • WC Resources
  • Best Practices
  • Industries
  • Return-to-Work Essentials

RSS Recent Blog Posts

  • WC Cost Containment For The Claims Management Team
  • Dealing with Long COVID in Work Comp
  • Common Mistakes: Medical Care and Accepting Every Claim – Article 3 of 3
SUBSCRIBE TO OUR FEE NEWSLETTER
Let Us Help You Stomp Down the High Cost of Workers' Comp!
Top of Page ↑
  • Home
  • Training Center
  • Search
  • Membership
  • Products
  • Blog
  • About
  • Contact
  • Subscribe
  • Login
Copyright © 2023 Amaxx, LLC. All Rights Reserved. · Privacy Policy / Legal Notice