As concern grows among advocates and policymakers about the potential for increased costs under health care reform, the leaders of Connecticut’s Health Insurance Exchange could be missing significant cost savings by not including the sixty non-hospital, community-based surgery centers in basic health plans
Under the federal Affordable Care Act – often called Obamacare – the states are to establish insurance exchanges, where consumers and small businesses would be able to purchase quality insurance for reasonable premiums.
A board of directors has been working here in Connecticut for more than 18 months, developing a framework, and establishing basic coverage that every insurer must include if their plans are to be offered on the exchange. Yet surgical centers, where the cost of care is up to 50 percent less than hospitals, are so far not included as cost-saving alternative.
The Hartford Surgical Center, Connecticut’s first such facility, was established in 1976 and is still in operation. Since then facilities have been located throughout the state, operating under the same regulations and accreditation and reporting standards as hospitals. The centers provide a high-quality, safe alternative for surgical procedures that do not require hospitalization.
Surgical centers are in most cases smaller than hospitals, and are located outside of urban areas, where patients can find easy access and reduced waiting times.
They offer a wide range of services to physicians and patients, providing care to Medicaid and Medicare recipients, managed care patients, self-pay, as well as those unable to pay.
Some centers specialize in a specific procedure, such as colonoscopies, which make the facilities more efficient and cost effective. Specialization of staff also results in better outcomes for patients.
Because the centers do not provide overnight or urgent care, as hospitals do, their costs are significantly lower. And because costs are lower, co-pays for Medicaid and Medicare patients are lower.
We will always need hospitals for emergencies and trauma care, and for surgeries that require a hospital stay, and our health insurance should cover that care.
Connecticut’s surgery centers, after nearly forty years of operation, are a well-established provider of health care.
If we are going to tackle the skyrocketing costs of health insurance, and if health care reform is going to have any success, we can and must include every option for cost savings. That means including surgical centers and their services for coverage in any health care plan offered by the Connecticut Health Insurance Exchange.
Ken Rosenquest is the president of the CT Association of Ambulatory Surgery Centers