Ambulatory Surgery Centers Are High-Quality, Low-Cost Key for Outpatient Procedures

^{Ambulatory surgery centers could benefit from data that are slated to come from a new ratings system.}

With so much emphasis on driving down healthcare costs in America, it is not surprising that hospitals and large healthcare systems are shifting their focus beyond the traditional walls of hospitals to ambulatory settings. Healthcare systems must find new ways to drive down costs to operate on razor-thin margins and rising costs, all while increasing patient satisfaction. One way to do that is by performing outpatient surgeries, also known as same-day surgeries, in ambulatory surgery centers (ASCs).

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Patients who are eligible for outpatient surgeries are generally healthier, and the nature of the surgeries is less complex. The procedures — such as cataract removals, colonoscopies, pain management, knee and shoulder repairs and other orthopedic procedures — are more routine. With the latest proposed changes to Centers for Medicaid and Medicare Services’ (CMS) reimbursements, hospitals and ASCs will be more closely aligned with how they are reimbursed, enhancing hospitals’ benefits for moving these procedures to ASCs and keeping the hospital operating rooms available for the more complex procedures requiring acute care resources.

This shift from hospital settings to ASCs has sparked a new dialog, greater consumer awareness and transparency. Despite a few negative claims, studies have suggested that ASCs have significantly better outcomes and lower infection rates, saving patients millions of dollars annually. ASCs’ quality reporting requirements and quality measures are almost double those of outpatient surgery in similar hospital settings.

So why do patients not know about ASCs as an option? There is no convenient reporting structure that allows for an easy-to-understand side-by-side comparison of ASCs, hospitals and hospital outpatient patient departments (HOPDs). Because of the variance in measures reported, consumers cannot get all the information unless they go to multiple sources. Organizations such as the Ambulatory Surgery Center Association (ASCA) and ASC state associations routinely collect quality data that are readily available to consumers. The problem is that most consumers are not familiar with ASCs and do not know where to go look for the patient satisfaction and quality data.

Reputable, independent organizations such as Leapfrog are jumping into to the ASC market to help close that gap. It is a compliment and validation of the ASC industry to have a traditionally hospital-focused research organization start to shine a light on outpatient surgery settings. Creating transparency and consumer awareness will show how safe the ASC setting is and that it is equal to, if not better than, the comparable hospital settings. That transparency will help overcome some of the negative attention that demonizes the ASC setting without a fair and balanced comparison to the large number of unpublicized hospital incidents and infections that unfortunately occur daily.

ASCs have decades of empirical data showing that they are a high-quality and low-cost-effective solution for outpatient surgical procedures for patients, providers and health systems. CMS recognizes this and has continued to increase the amount of allowable procedures in the ASC setting. Furnishing independent research and creating awareness will help dispel misconceptions and help consumers make more informed decisions about the quality, costs and available choices for outpatient surgery.

Tara Vail, M.B.A., is the chief operating officer of HSTpathways and a board member of the California Ambulatory Surgery Association.

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