In January, Medicare started paying for six types of percutaneous coronary intervention, or PCI, procedures, also known as angioplasties, which it previously paid for only in inpatient or hospital outpatient settings. The CMS reimburses ASCs about 40% less for these services than it pays for hospital outpatient care. In fiscal 2018, it covered more than 150,000 of these procedures at a cost of about $1 billion in facility fees alone, according to CMS data. The CMS rule allowing ASCs to perform these lucrative PCI procedures, finalized last November, is widely expected to speed the migration of cardiovascular procedures out of hospitals and into the ambulatory sites. The Medicare payment policy change has spurred a rush by ambulatory surgery companies, independent cardiology groups, some hospitals, private equity investors and insurers to enter into or expand their ambulatory cardiovascular business. Cardiology groups and ASCs specializing in cardiovascular care say they’re being swamped with acquisition and joint venture offers.
Read the full article: Medicare Payment Change Will Shift Lucrative Heart Procedures out of the Hospital //
Source: https://www.modernhealthcare.com/outpatient/medicare-payment-change-will-shift-lucrative-heart-procedures-out-hospital