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Quality of Care in Ambulatory Surgery Centers

Quality care is a hallmark of the ASC community since its earliest days.

As ASCs have transformed the outpatient experience for millions of Americans, they have done so with a strong track-record of quality care and positive patient outcomes.

ASC Regulation

All ASCs are subject to rigorous oversight and independent inspections to assess each center’s level of compliance with both state and national standards. These on-site surveys, like those conducted at hospitals and other facilities, evaluate ASCs on a wide range of demanding clinical, operational and quality standards.

Currently, there are more than 5,400 Medicare-certified ASCs throughout the country that meet or exceed the health and safety standards set by the Centers for Medicare & Medicaid Services (CMS). All Medicare-certified ASCs must also comply with an extensive set of infection prevention standards that are monitored internally at each ASC daily and evaluated by external inspectors trained in the use of a rigorous, detailed infection prevention survey tool. Click here to learn more about the specific federal requirements governing ASCs.

In addition, more than two-thirds of ASCs seek voluntary accreditation from one of four accrediting bodies, which are recognized by CMS for their high standards and ability to evaluate health care settings. State-specific licensure is also required by most states for ASCs to operate (e.g., ongoing inspection and reporting).

What the Experts are Saying

A study published in Health Affairs found that ambulatory surgery centers (ASCs) saved money and increased efficiency for Medicare, insurers and patients alike, while providing the same high quality care as hospital outpatient departments (HOPDs). The study, conducted by health economists Elizabeth Munnich of the University of Louisville and Stephen Parente of the University of Minnesota, concluded that “ASCs are a high-quality, lower-cost substitute for hospitals as venues for outpatient surgery.”

Speaking at a briefing at the National Press Club in Washington, DC, Professor Munnich said that ASCs provide a cost efficient surgical environment in which “surgeons can perform more cases [and] staff can perform more cases.” “Ultimately,” she continued, “the implication is that insurers—whether public or private—would generate savings which would theoretically be passed onto patients.”

Analyzing data from more than 50,000 surgical procedures over four years, the authors found that ASCs not only saved money and increased efficiency, but also “provide high quality care, even for the most vulnerable patients.” The authors warned, however, that “recent [Medicare] reimbursement changes have lowered payments to ASCs, which reduces the incentives to start or expand these facilities.”

“Professors Munnich and Parente are only the latest experts to conclude that ambulatory surgery centers save billions while maintaining high-quality surgical care,” said William Prentice, chief executive officer of the Ambulatory Surgery Center Association. “Their findings show that ASCs could save billions more than they do currently if policymakers took steps to ensure that patients have improved access to the services ASCs provide.”

The full study “Procedures Take Less Time At Ambulatory Surgery Centers, Keeping Costs Down And Ability To Meet Demand Up” can be read in the May 2014 issue of Health Affairs.