I have known for a while about the Surgery Center Network, a web site that connects self-pay patients (as well as some third-party payers such as employers and even a couple of insurance companies) with ambulatory surgical centers, which are basically small, specialized surgical facilities. The reason I’ve held off on writing about them has been that the web site seemed to still be in its ‘beta’ stage, with a lot of functionality still undone. Without a fully or at least mostly functioning site, I didn’t think it was worth writing it up.
I’m pleased to say that the Surgery Center Network web site now is up and running well enough that it should be easy enough for anyone wanting to find inexpensive surgical options.
First, a word about ambulatory surgical centers. These facilities have been around for more than four decades, and are a well-established part of the health care world. The Ambulatory Surgical Center Association (ASCA) describes them as follows:
Ambulatory surgery centers (ASCs) are health care facilities that offer patients the convenience of having surgeries and procedures performed safely outside the hospital setting…
Forty years ago, virtually all surgery was performed in hospitals. Waits of weeks or months for an appointment were not uncommon, and patients typically spent several days in the hospital and several weeks out of work in recovery. In many countries, surgery is still performed this way, but not in the US… The first facility was opened in Phoenix, Arizona, in 1970 by two physicians who saw an opportunity to establish a high-quality, cost-effective alternative to inpatient hospital care for surgical services. Faced with frustrations like scheduling delays, limited operating room availability, slow operating room turnover times, and challenges in obtaining new equipment due to hospital budgets and policies, physicians were looking for a better way―and developed it in ASCs.
… By operating in ASCs instead of hospitals, physicians gain increased control over their surgical practices. In the ASC setting, physicians are able to schedule procedures more conveniently, assemble teams of specially trained and highly skilled staff, ensure that the equipment and supplies being used are best suited to their techniques, and design facilities tailored to their specialties and to the specific needs of their patients. Simply stated, physicians are striving for, and have found in ASCs, professional autonomy over their work environment and over the quality of care that has not been available to them in hospitals…
The Surgery Center Network’s web site offers some comparisons between hospitals and ASCs:
Hospital or ASC… What’s the Difference?
The decision about where to have your surgery conducted is a personal one. When considering your options, it’s important to understand some of the differences between an Ambulatory Surgery Center (ASC) and hospital or hospital-based facility. Here are a few factors to consider:
Cost: The cost of a procedure at an ASC is typically 45-60% less than a hospital setting, but sometimes as high as 80-90% less.
Patient Satisfaction: Patient surveys reveal a 92% satisfaction rate with both the care and service they receive from ASCs. Patients rate hospitals with a 70% high satisfaction rate following a hospital surgery procedure.
Ownership: Most ASCs are physician-owned, which allows for maximum professional control over the clinical environment and the quality of care delivered to patients.
Specialization: ASCs are able to focus on a specialized number of procedures, allowing physicians to design an environment that optimizes their ability to provide a high-quality, patient-centered surgical experience.
Scheduling: ASCs can exercise better control over scheduling, so virtually no procedures are delayed or rescheduled due to unforeseen factors such as emergency room demands.
Timeliness: At least 70% of surgeries in an ASC start within seven minutes of their scheduled time. Additionally, 77% of ASC cases are finished within the scheduled time, compared to 38% at a hospital facility.
Infection Rates: All Medicare-certified ASCs must comply with an extensive set of infection prevention standards that are monitored at each ASC daily and evaluated by external inspectors. ASCs have an excellent track record of providing safe patient care, and as a result ASCs experience only one surgical site infection per 1,000 patients on average. Estimated national average of surgical site infection rates at hospital facilities is around 2% (or 20 per 1,000 patients).
For self-pay patients, the combination of low cost and high quality, not to mention convenience, provides a great option for people needing surgery. And while ambulatory surgical facilities typically only provide services that don’t require an overnight stay, Surgery Center Network also can find facilities for both short-term and long-term inpatient surgical treatment (I’d guess by working with what are known as either specialty hospitals or physician-owned hospitals, which are like ASCs but offer inpatient care).
The savings for using Surgery Center Network can be substantial. On their home page they have a drop-down menu of procedures, giving three prices for each. The first is labeled ‘Hospital Cost’ which I’d assume is an average of ‘chargemaster’ rates, the second is ‘Managed Care Cost’ which I’d guess is what insurers typically pay, and the third is ‘Surgery Center Network Cost’ which is an average for what self-pay patients would pay if they used the services of Surgery Center Network.
And as is the norm for self-pay patients, using a service like Surgery Center Network will usually result in significant savings.
For example, using the site Pricing Healthcare and looking at Los Angeles-area information, a carpal tunnel release procedure shows a range of list prices between $5,481 and nearly $33,000 and a cash price of $3,837 at UCLA Ronald Reagan Medical Center. Prices for more than twenty hospitals are given, with most of them falling between about $8,500 and $16,000. Most of them don’t give cash prices, but the others that do range from about $7,100 to $26,500.
The same procedure (at least I assume so – medical codes aren’t my specialty, but they appear to be identical) through Surgery Center Network would be $2,990, at least on average. And these are ‘all-inclusive’ prices, meaning the surgeon, facility, and anesthesiologist fees are all bundled into a single price.
If there’s one weakness to the Surgery Center Network web site it’s that it doesn’t give any indication of the geographic distribution of ASCs that are in their network of cash-friendly facilities, at least not currently. The site does have a tool called ‘Procedure Navigator’ that will allow you to enter your zip code and find facilities near you that are part of the network, but it appears that it hasn’t been built yet.
Otherwise the process seems fairly simple for self-pay patients who want to use the services of SCN. They just need to sign up for a free account on the web site, and from there they contact a Case Manager who will work with them to find the right ASC at the right price.
Hospital-based care is probably the most expensive option for self-pay patients. Sometimes it’s unavoidable of course, but in many cases you can find affordable, high-quality alternatives. The Surgery Center Network is a great tool for anybody needing to pay directly for surgical care, and I would highly recommend it as a resource for self-pay patients.
***UPDATE: I’d e-mailed Surgery Center Network with a few questions before posting this, and they have since gotten back to me to tell me that they have about 500 ASCs around the country in their network, and they do use specialty hospitals for inpatient surgery cases. I’ve actually done some research on specialty hospitals for a think tank, and they have just as high a quality of care as the ASCs, in particular having been able to dramatically reduce hospital-acquired infections.