Issue 1
ASGE believes that the update should be the market basket used for the hospital outpatient department because the costs of providing services in both settings are very similar. The hospital market basket measures changes in the cost of hospital labor, supplies, equipment, and overhead and is a better measure of ASC cost inflation than CPI, which measures changes in the cost of goods and services purchased by urban consumers. ASC’s must compete in the same labor market for personnel and pay competitive salaries. Moreover, the identical medical supplies and equipment purchased by ASCs are also purchased by hospitals. Finally, ASCs and hospitals both need to maintain liability insurance. Thus, the changes in the cost of the market basket of goods and services from one year to the next experienced by hospitals would apply to ASCs as well. In contrast, there is no reason to believe that an index which measures the changes in the costs of housing, food, clothing and shelter experienced by consumers applies to ASCs. ASGE asks that Congress direct CMS to adopt the hospital market basket as the basis for the annual update for ASC payments.