When Patients Have to Pay the Difference, They Choose Less Expensive ASCs for Care

By Jim Burger

The more financial responsibility patients share with their insurers, and the more they understand the disparity in prices charged by freestanding ambulatory surgery centers and hospital-based outpatient facilities, the more likely they are to choose less-expensive ASCs for orthopedic surgery, a new study finds. Patients who choose ASCs, the study finds further, do not have more complications.

The study, which appears in the Journal of Bone & Joint Surgery, examined the impact of a reference-based insurance plan adopted by the California Public Employees’ Retirement System (CalPERS) in 2012. Under such a plan, patients are responsible for the difference between a payer’s fixed contribution for a given procedure and the provider’s ultimate charge.

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