…and will only help the legislature allow for patients to access health care in less expensive settings (like Ambulatory Surgery Centers) by reforming North Carolina’s outdated Certificate of Need law.
The charts below compare cost differentials of average charges for an ACL repair and a cataract removal — two of the most common outpatient surgeries. These figures are taken from Blue Cross and Blue Shield of North Carolina’s publicly accessible cost estimator tool.
The state’s dominant middleman, Blue Cross and Blue Shield, may be sitting on the sidelines with CON reform, but their price transparency tool is only providing more ammo for those pushing a long overdue fix to the law. The insurer fears that substantial increases in utilization will outweigh lower provider reimbursement in smaller health care settings. Just the opposite transpired since 2005, when CON was loosened to allow for colonoscopies to be performed by gastroenterologists in their own endoscopy units. Utilization did increase by 28 percent over four years, in part due to the state’s baby boomer population, but overall Medicare savings still amounted to over $224 million within six years.
