Cost Comparison of Sports Medicine Procedures in Ambulatory Surgery Centers Versus Hospital Outpatient Departments for Medicare Recipients

Background: Healthcare costs in the United States are rising in conjunction with an increased utilization of outpatient centers, particularly in sports medicine. Purpose/Hypothesis: The primary purpose of this study was to utilize Medicare data to compare the overall cost of sports medicine procedures performed in the ambulatory surgery centers (ASCs) and hospital outpatient department (HOPD) settings. The secondary purpose of this study was to compare facility fees, surgeon fees, Medicare payments, and patient payments between ASCs and HOPDs. It was hypothesized that procedures performed at ASCs would demonstrate a lower overall cost than those performed at HOPDs. Study Design: Cross-sectional study. Methods: Publicly available data from the Centers for Medicare P <. 001), facility fees (2777 ± 1020 vs 5416 ± 1606; P <. 001), Medicare payments (2898 ± 928 vs 5009 ± 1407; P <. 001), and patient payments (724 ± 232 vs 1252 ± 352; P <. 001) compared with HOPDs. Knee procedures (n = 31) at ASCs had lower total costs (4236 ± 2741 vs 6668 ± 3341; P =. 006), facility fees (3408 ± 2507 vs 5840 ± 3116; P =. 006), Medicare payments (3389 ± 2193 vs 5458 ± 2955; P =. 006), and patient payments (847 ± 548 vs 1209 ± 429; P =. 011). Hip procedures (n = 6) at ASCs had lower total costs (3583 ± 698 vs 6671± 1451; P =. 025), facility fees (2725 ± 669 vs 5813 ± 1431; P =. 025), Medicare payments (2866 ± 558 vs 5336 ± 1161; P =. 025), and patient payments (716 ± 139 vs 1333 ± 290; P =. 025) compared with HOPDs. Conclusion: Our study demonstrates that sports medicine procedures performed at ASCs for Medicare recipients result in considerable overall total cost savings when compared with those performed at HOPDs. Sports medicine providers should be aware of differences in costs when determining the best setting for these procedures.