Northwest ENT Surgery Center in Woodstock, Georgia, started observing a trend around 2011–2012, says Shatul Parikh, MD, otolaryngologist and medical director of the ASC.

“There was a change in the tide of the insurance market,” he says. “The Affordable Care Act marketplace and employers started offering higher deductible plans. When patients had a $250 or $500 deductible, surgery was affordable, regardless of the type of procedure. Then deductibles started to rise sharply.”