St. George Surgical Center administrator speaks to Congress about reducing health care costs

October 19, 2018 Utah Channel 3

ST. GEORGE — In the midst of seemingly endless debate about America’s rising health care costs, St. George Surgical Center Administrator Ty Tippets was invited to speak to the U.S. Senate Health, Education, Labor and Pensions Committee about how cost transparency can reduce spending and empower patients when making health care decisions.

Sen. Lamar Alexander speaks to Ty Tippets and Bill Kampine at a U.S. Senate Health, Education, Labor and Pensions Committee hearing, Washington D.C., Sept. 18, 2018 | Photo courtesy of the U.S. Senate Health, Education, Labor and Pensions Committee, St. George News

Tippets testified last month alongside three other ambulatory surgical center executives in Washington, D.C.

Ambulatory surgical centers specialize in providing outpatient surgical and preventative services at a lower cost than hospitals can provide. In his testimony, Tippets shared St. George Surgical Center’s experience with an initiative to bundle surgery fees and make prices accessible on their website.

The bundle includes surgeon fees, facility fees, anesthesia and any surgical implants into one price. To date, they have posted the prices of 220 outpatient procedures they offer. They were one of the first ambulatory surgical centers in the nation to begin openly sharing the cost of their procedures online.

“Anytime that happens, it will help the consumer make some informed decisions,” Tippets said.

Eighty-nine percent of patients want to know what their medical costs will be, but only 26 percent of them actually make the effort to find out because of the inconvenience of doing so, Tippets said, adding that health care is one of the only industries where consumers do not feel the need to know what the cost of service will be beforehand.

Making prices easily accessible to consumers allows them to research and make informed decisions about where they should go for health care, Tippets said, which will ultimately reduce the cost of health care through free market competition.

“I really believe that the power of an educated consumer that can search for creative solutions will help fix our health care as fast as anything out there. Especially a free market where there’s good competition,” Tippets said. “I think that’s the first step to addressing the high cost of health care in our system.”

Tippets suggests that insurance companies and physicians refer patients to ambulatory surgical centers and other lower-cost facilities instead of the more expensive hospital outpatient departments in order to reduce the national cost of health care.

Nationally, ambulatory surgical centers save Medicare around $2.5 billion a year, Medicare beneficiaries $1.5 billion a year and private patients approximately $40 billion a year.

In his testimony, Tippets said that Medicare, insurers and other payers should encourage patients to seek lower-cost settings and look to more innovative methods, such as initiating tiered co-payments, to give patients the incentive to seek lower cost care. He said payers should also publicly post information about amounts covered or the beneficiaries’ out-of-pocket liability for care.

Consumers should not only look at cost, but also at the quality of services and patient safety — higher cost does not necessarily translate into higher quality, Tippets said in his testimony.

Leah Binder, Bill Kampine, Nancy Giunto and Ty Tippets testify in front of the U.S. Senate Health, Education, Labor and Pensions Committee, Washington D.C., Sept. 18, 2018 | Photo courtesy of the U.S. Senate Health, Education, Labor and Pensions Committee, St. George News

St. George Surgical Center performs approximately 4,500 procedures on 2,600 patients annually. The center offers lower prices, which can save patients 60-90 percent on cost while also offering high quality care. By using best practices, the center says it maintains a low infection rate of 0.037 percent and a 99.6% patient satisfaction rate.

While both surgical centers and outpatient departments are required to report on a variety of incidents, the difference in reporting requirements between the two at a federal level make it impossible to accurately compare quality and outcomes between them. For instance, surgical centers are required to report patient burns, patient falls, wrong site surgeries and hospital transfers for Medicare and Medicaid patients through the Centers for Medicare and Medicaid Services Quality Reporting Program.

“If patients can choose to get their care from either an ASC or a hospital, shouldn’t it be easy for them to compare price, safety and quality metrics in both settings,” Tippets asked in his testimony. “That is not the way things work now, and we need to address that.”

Surgical centers have been consistent in their reports on these incidents, so much so that CMS recently proposed to eliminate them from their reporting system. However, the surgical centers themselves have requested that they continue to be required to report incidents and even expand them to include all patients, not just those with Medicare and Medicaid, and for all other surgery centers to do the same so patients have a more accurate picture of the quality of the center.

“I really think that as we look at empowering patients out there, empowering consumers, we can really go a long way to help address the cost of health care,” Tippets said.

Email: mshoup@stgnews.com

Twitter: @STGnews | @MikaylaShoup