It stinks when facts get in the way of a good story. As I prepared to write today’s post, I knew the lead-in that I would use, a perfect set-up for my point today. Except that the story is not true at all; just an old apocryphal tale that lives in the fertile soil of the internet.
NASA did not spend millions, much less billions, developing an ink pen that would write in space even as the oh-so-smart Russian cosmonauts laughed at us while using a cheap pencil.
Real truth: Pencils are problems (flammable…not good in an environment that is at times 100% oxygen; floating broken lead pieces not a good idea). A private pen company did spend about $1M of its own money to develop an anti-gravity pen that both countries used – at a price of about $2.39 per pen.
But, dang it, were this story true it would be perfect here. And since I have no better idea, let’s just pretend it is. My kids will tell you I make up crap all the time, so nothing new here.
Last week, we noted the 2020 results of the Medicare Shared Savings Program, the largest of the government’s value-based care initiatives. After years of sputtering outcomes, MSSP saved $4.1B, a net of $1.9 billion to CMS after the bonuses were paid out to the participating ACOs. A couple billion is nothing to sneeze at, but it has taken a lot of work to make that happen.
In the meantime, UnitedHealth Group released a study about how much could be saved if we moved simple, common surgical procedures from hospital outpatient departments (HOPD) to ambulatory surgery centers (ASC).
Disclosure: Yes, UHG has not one, but two dogs in this hunt. They are not only a payer, but also the owner of a lot of ASCs. But you can be biased and still be right.
Common procedures done in the HOPD setting in 2019 cost, on average, $7,716 each. The same procedures in an ASC averaged $3,157, a savings of over $4,500 for each case.
There are over 6 million outpatient procedures done in HOPDs each year and only about 10% of them are for complex patients (e.g., morbid obesity, multiple comorbidities, etc.) that should be kept close to a hospital, just in case.
Do any math you want –how many of those are Medicare patients, how many move to the ASC – and you quickly get a number that blows way past $2 billion. Just by moving routine same day surgeries from the HOPD to an ASC.
See? The NASA pen story would have been perfect…millions spent developing a pen vs. just using a school child’s #2 pencil.
Though the NASA story is not true, unfortunately the ACO/MSSP story is.
How about we do the easy thing first?