BY JOHN STARK for The Bellingham Herald
Thanks to advances in medical technology, many surgery patients who would once have faced a few nights in a hospital are now getting complex procedures done at outpatient clinics that can get them in and out in less than a day.
The trend toward replacing lengthy hospital stays with an outpatient approach began in the 1970s, grew steadily and still appears to be gaining momentum. There is much more at stake than patient convenience: Outpatient surgery is far less costly to patients, insurers and the government programs that pay medical bills for millions of people. 
That’s because hospitals must charge enough to cover their extensive overhead costs, which are far less in an outpatient clinic.
Pam Novotny, administrator at Bellingham Ambulatory Surgery Center at 2075 Barkley Boulevard, provided some examples:
▪ For cataract surgery, Medicare reimburses a hospital about $1,800. An ambulatory surgery center gets less about $1,100.
▪ For inguinal hernia repair, a hospital gets about $2,900, while a surgery center gets about $1,700.
▪ A breast lumpectomy costs Medicare about $2,500 in a hospital, compared to about $1,200 at a surgery center.
Gary Richberg is administrator at Pacific Rim Outpatient Surgery Center, 3009 Squalicum Parkway next to Peace Health St. Joseph Medical Center. Richberg said Pacific Rim is Bellingham’s largest surgery center, with about 5,000 surgeries performed there each year.
Richberg estimated that about 35 percent of procedures at Pacific Rim are knee and hip surgeries, including full joint replacements that once involved costly hospital stays of three to four days. Medical and professional journals report that an increasing number of such surgeries are being done at surgical centers instead of in hospitals, mostly because the cost is thousands of dollars less.