Blue Cross Blue Shield Association study shows how consumers save with shift to Outpatient Care

A new study by the Blue Cross Blue Shield Association (BCBSA) demonstrates how much consumers and payers save when medical procedures shift from an inpatient to an outpatient setting.

The study, “How Consumers Are Saving with the Shift to Outpatient Care,” examines four common shoppable* procedures – hysterectomy, lumbar/spine surgery, angioplasty and gallbladder removal – from 2010 to 2014. These four procedures cost Blue Cross and Blue Shield companies, their members and employers nationwide an estimated $11 billion in 2014.

KEY FINDINGS: Patients who utilized outpatient procedures saved money in 2014:

  • $320 on average for lumbar/spine surgeries
  • $483 for hysterectomies
  • $924 for gallbladder removals
  • $1,062 for angioplasties

Total average costs for consumers, payers and employers in 2014 also went down when shifting to the outpatient setting:

  • $4,505 per hysterectomy
  • $8,475 per lumbar/spine surgery
  • $11,262 per gallbladder removal
  • $17,530 per angioplasty

“Performing procedures in the outpatient setting will continue to provide valuable cost savings,” said Maureen Sullivan, chief strategy officer and senior vice president of strategic services for BCBSA. “These savings will be especially important for members when they need surgical care and will help them save money.”

This report** also measured the varying shifts from inpatient to outpatient settings for each of the four procedures. Hysterectomy underwent the most dramatic shift during the study period, with the proportion of outpatient procedures increasing from 36 percent to 64 percent, while the proportion of outpatient lumbar / spine surgery grew from 61 percent to 82 percent. Angioplasty’s outpatient share increased modestly from 43 percent to 50 percent.  Laparoscopic gallbladder removal remained essentially flat at 80 percent, having already shifted to mostly outpatient by 2010.

“For appropriate patients, outpatient surgery has been shown to be safe and effective, achieving similar or better outcomes as inpatient procedures while allowing patients to spend less time in a medical facility, recover faster and incur less pain,” Sullivan said.

Spine surgery and angioplasty have been shown to be safe and are associated with similar or better outcomes in the outpatient setting. Additionally, outpatient hysterectomy was found to have fewer 30-day complications, lower risk of perioperative morbidity, less risk of wound complications and other medical complications compared to inpatient, even after adjusting for demographic and operative differences between the two groups***.

This study is the fifth by Blue Cross Blue Shield, The Health of America Report, a collaboration between BCBSA and Blue Health Intelligence, which uses a market-leading claims database to uncover key trends and provide insight into healthcare affordability and access to care.

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