2005 survey fees will be increased

The Joint Commission on Accreditation of Healthcare Organizations’ survey fees will increase for 2005. The fee increase, only the second in the last decade, will vary by program and, within programs, will vary by the types and volumes of services provided.

The Joint Commission also announced plans to institute a subscription billing model in 2006 that will allow accredited organizations to begin to spread their survey fees over the three-year accreditation cycle. The Joint Commission has significantly changed the survey process in the past two years and added a variety of new services that have increased the costs of conducting surveys, says Dennis S. O’Leary, MD, president, Joint Commission.

The final fee schedule had not been set as of Same-Day Surgery publication date but the estimated average increase for ambulatory care surveys is $810 and for hospitals is $2,700.

For specific pricing for your same-day surgery program, contact the Joint Commission Pricing Unit at (630) 792-5115 or pricingunit@jcaho.org.

Cost, revenue information available on PA centers

Detailed cost and revenue information for all ambulatory surgery centers (ASCs) in Pennsylvania is available in a recent report from the Pennsylvania Cost Containment Council.

The report also highlighted higher ASC margins compared to hospitals and other providers is largely driven by the way ASC report their net income on a pretax basis, according to the American Association of Ambulatory Surgery Centers (AAASC). In Pennsylvania, ASC uncompensated care is at 1.11%, compared to 2.07% for hospitals, according to the AAASC. The rapid growth of ASCs has not had a major effect on the overall volume of outpatient care provided by hospitals, AAASC said in its report.

A copy of the report is available at www.aaasc.org/advocacy/ASCFactSheet.htm. At the bottom of the page, click on "Pennsylvania Health Care Cost Containment Council Report."

GAO: Hospitals not getting enough reimbursement

Report targets drugs, devices for outpatients

Hospitals may not be receiving adequate reimbursement for drugs, devices, and other services provided in the outpatient setting because of a flawed rate-setting methodology used by the Centers for Medicare & Medicaid Services (CMS), according to a recently released report from the Government Accountability Office (GAO).

Based on information from 113 hospitals, the GAO found that charge-setting methodologies for drugs, devices, and other outpatient services vary greatly across hospitals and across departments within a hospital. CMS’s methodology does not recognize hospitals’ variability in setting charges, and therefore, the costs of services used to set payment rates may be under- or overestimated, the GAO pointed out.

GAO recommended that the administrator of CMS collect data on excluded claims and analyze variation in hospital charges to determine if the outpatient payment rates uniformly reflect hospitals’ costs of providing outpatient services, and, if they do not, to make appropriate changes to the methodology. CMS stated that it will consider GAO’s recommendations.

(Editor’s note: For a copy of the report, go to www.gao.gov. Search for "GAO-04-772.")