As it becomes more evident that ambulatory surgery centers (ASCs) are both cost-effective and preferred by most patients, operators are left to prove that the outpatient setting is just as safe as a hospital. 

For example, cardiovascular procedures began shifting into the outpatient setting in 2020, when percutaneous interventions (PCIs) were added to the Centers for Medicare & Medicaid Services (CMS) covered procedure list. 

The inclusion happened only after cardiologists banded together to prove that some procedures were indeed safe to perform at ambulatory surgery centers. 

There is a growing movement to collect data and outcomes on ASC safety and quality metrics. To this tune, the ASC Quality Coalition launched the ASC Safety & Quality Assessment in August 2024, to offer a streamlined platform for ASCs to report on key quality and safety metrics. 

“ASCs have a great record for both patient safety and high-quality outcomes,” Kathy Wilson, executive director of the ASC Quality Coalition, told ASC News. “The assessment is another way for centers to stay on top of these issues, backed by useful toolkits and quarterly benchmarking data.”

The process is user-friendly, taking roughly 20 minutes to complete, Wilson said. Participating ASCs receive detailed reports comparing their center’s data with others, allowing them to identify areas for improvement.

“We’ve built the assessment to be as straightforward as possible,” she said. “Feedback from the 143 centers that participated in the pre-release has been overwhelmingly positive regarding its simplicity and the value of the provided resources.”

ASCs face some unique challenges in implementing new CMS measures, especially since many were designed for hospitals and haven’t been tested in the ASC environment. For example, a new measure on patient-reported outcomes for hips and knees may be manageable for hospitals with electronic records and resources, but for many ASCs, data collection would need to be done manually, adding significant costs. 

“You have to balance the cost of implementing these measures against the consequences of not participating in the Quality Reporting Program, and I think we’re going to get to the point where some surgery centers will probably evaluate that,” she said. “It’s challenging for centers that don’t have the structure or systems in place to collect, compile and report all this information.”

The ASC Quality Coalition is actively working with regulatory bodies like CMS and the CDC to ensure that the measures used in ASCs are meaningful, Wilson said. The survey also gives operators the opportunity to appeal to payers.

“We talked to some payers when we were developing the survey to find out what kinds of things would be important to them. We are going to rely on the centers to share the information with the payers,” Wilson said. “We won’t be releasing the results of the center’s survey; they will be working directly with a payer, hopefully to provide that information. We’re hoping it’ll be helpful – something concrete that they can provide when they’re trying to set up a contract.” 

Looking ahead, the ASC Quality Coalition aims to continue working with regulatory agencies and industry stakeholders to refine and expand the platform. The February 2025 offering of the assessment promises to include even more participants, Wilson said. 

“Our long-term goal is to ensure that the quality data we’re collecting has real meaning and helps ASCs continuously improve,” she said. “We also want to be a resource hub for ASCs, providing the tools they need to succeed.”