Skip to Main Content
HBS Home
  • About
  • Academic Programs
  • Alumni
  • Faculty & Research
  • Baker Library
  • Giving
  • Harvard Business Review
  • Initiatives
  • News
  • Recruit
  • Map / Directions
Faculty & Research
  • Faculty
  • Research
  • Featured Topics
  • Academic Units
  • …→
  • Harvard Business School→
  • Faculty & Research→
Publications
Publications
  • Article
  • Health Affairs Blog

The CMS New Rule on Ambulatory Surgical Centers Earns Only Partial Credit

By: Junaid Nabi and Robert S. Kaplan
  • Format:Electronic
ShareBar

Abstract

The Centers of Medicare and Medicaid Services (CMS) recently announced that it will be removing more than 250 musculoskeletal surgeries from its “inpatient-only list” in January 2022. An additional 1,500 surgeries will be eliminated in the following year. The change provides more flexibility for patients and physicians, lowers costs, and promotes competition between hospitals and independently owned ambulatory surgical centers (ASCs). It will also allow more surgeries to be performed in facilities that do not treat patients with infectious diseases, legitimizing ASCs as the “right place for the right care” for the many surgeries with low likelihood of complications. CMS, however, failed to change its reimbursement practices in which physicians receive lower fees and patients incur higher co-pays when surgeries are performed in ASCs. This omission will cause many hospitals, surgical practices, and patients to prefer in-hospital to ASC-based surgeries. CMS can remedy this gap by changing historical payment policies that dis-incentivize surgeries performed in ASCs.

Keywords

Ambulatory Care; Payment Policy; Health Care and Treatment; Governing Rules, Regulations, and Reforms

Citation

Nabi, Junaid, and Robert S. Kaplan. "The CMS New Rule on Ambulatory Surgical Centers Earns Only Partial Credit." Health Affairs Blog (June 2, 2021).
  • Read Now

About The Author

Robert S. Kaplan

Accounting and Management
→More Publications

More from the Authors

    • May 2023
    • NEJM Catalyst Innovations in Care Delivery

    Decarbonizing Health Care: Engaging Leaders in Change

    By: Vivian S. Lee, Kathy Gerwig, Emily Hough, Kedar Mate, Robert Biggio and Robert S. Kaplan
    • April 3, 2023
    • Harvard Business Review Digital Articles

    Getting a Clearer View of Your Company’s Carbon Footprint

    By: Robert S. Kaplan, Karthik Ramanna and Stefan Reichelstein
    • 2023
    • BMC Health Services Research

    Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital

    By: Ricardo Bertoglio Cardoso, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges and Carisi Anne Polanczyk
More from the Authors
  • Decarbonizing Health Care: Engaging Leaders in Change By: Vivian S. Lee, Kathy Gerwig, Emily Hough, Kedar Mate, Robert Biggio and Robert S. Kaplan
  • Getting a Clearer View of Your Company’s Carbon Footprint By: Robert S. Kaplan, Karthik Ramanna and Stefan Reichelstein
  • Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital By: Ricardo Bertoglio Cardoso, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges and Carisi Anne Polanczyk
ǁ
Campus Map
Harvard Business School
Soldiers Field
Boston, MA 02163
→Map & Directions
→More Contact Information
  • Make a Gift
  • Site Map
  • Jobs
  • Harvard University
  • Trademarks
  • Policies
  • Accessibility
  • Digital Accessibility
Copyright © President & Fellows of Harvard College