U.S. News unveils second ranking of top ambulatory surgery centers

With more people opting to get procedures done outside the hospital, U.S. News & World Report has released its second ranking of the nation’s ambulatory surgery centers.

U.S. News released its rankings today. The media outlet unveiled its inaugural list of the best ambulatory surgery centers last year, which comes after compiling rankings of America’s top hospitals for more than three decades.

The organization examined 4,357 ambulatory surgery centers in four specialty areas: colonoscopy & endoscopy; ophthalmology; orthopedics & spine; and urology. U.S. News performed the analysis in collaboration with CareJourney by Arcadia.

U.S. News ranked 733 ambulatory surgery centers, or about 17% of those examined, as the nation’s best performers.

In its rankings, U.S. News examined the data on the outcomes of patients, including how many suffered complications or required a hospital stay, says Chelsey Wen, senior health data analyst at U.S. News.

“We're looking at any emergency department visits that occur within, mostly, the 30 days after the initial procedure is done,” Wen tells Chief Healthcare Executive®. “We're looking at inpatient admissions, we're looking at mortalities. We're looking at length of stay in post-acute facilities like nursing homes.”

The analysis examines patients who are on Medicare, and Wen says some facilities are hoping that the rankings eventually include individuals using commercial insurance and Medicare Advantage plans. Wen says in the future, U.S. News hopes to expand the analysis to a broader set of patients.

U.S. News factored in the medical history of patients and other risk factors to provide a fair evaluation of the performance of surgery centers, Wen says.

The top surgery centers generally saw fewer patients suffering complications. The top-ranked facilities by U.S. News saw 35% fewer visits to emergency departments than typical surgery centers.

The best surgery centers with orthopedics and spinal surgeries had a complication rate that was about 37% lower than other facilities. For ophthalmology procedures, the top performers had a complication rate 54% lower than other surgery centers, U.S. News said.

Consumers have been utilizing the U.S. News ranking of ambulatory surgery centers, but Wen says she has been surprised at the level of interest from the providers.

“I think the initial goal that we had was to fulfill the consumer need to see these quality metrics for ASCs,” Wen says. “And we were pleasantly surprised to see that it also fulfilled a similar need for ASC operators, those that own and manage ASCs as well, because they had previously said that they were unsatisfied with the existing quality metrics for ASCs."

“And with the ratings that we are creating and reporting, they're able to see a more granular performance of their ASCs, they're able to see a more longitudinal trend. And because of that, they're able to look at the gaps and opportunities that they can address to improve their performance,” she says. “It's something that we appreciate, but we didn't necessarily see coming. I mean, we did get constructive criticism as well, which is to be expected, because it was our first year.”

While many providers demonstrated consistency, Wen says she was a little surprised at the variance in performance from one year to the next.

“I will say that the ASC industry does look a lot more volatile compared to hospitals, and I think that's just the nature of it, because some of these are privately owned and operated. They switch ownership often,” Wen says. “There was, I think, more change than we expected, especially because we've been working on hospitals for so long.”

Some surgery centers will add or drop procedures, which can change their rankings. She also notes that many ambulatory surgery centers are simply newer and, unlike some hospitals, haven’t been around for a century or more.

Most of the surgery centers examined by U.S. News have an average rating, which should provide some comfort to consumers, Wen says.

“I think that is a reassuring thing, because that essentially means that there are no red flags for safety or quality for these places,” Wen says. “And you know, most of the ASCs are rated as average. So I think for patients, what that means is that no matter where you are, there is going to be an ASC in your area that can likely meet your needs and be rated as safe by us.”

In the future, U.S. News hopes to add more specialty care services in its analysis, including cardiology, Wen says. She says the analysis will become more refined and noted U.S. News did take some lessons from its first year. U.S. News opted not to rate surgery centers that are only providing back pain injections, because the complexity and risk isn’t comparable to facilities that are performing surgeries such as hip replacements.

“We are continually trying to improve the methodology,” Wen says. “It's only our second year. I'm sure we'll get a lot of great feedback.”

Health systems continue to see a greater demand in outpatient services, analysts say.

These states had the most top ambulatory surgery centers, as ranked by U.S. News.

California (95)

Florida (64)

Texas (54)

Pennsylvania (36)

Maryland (34)

Georgia (29)

New York (25)

Ohio (23)

Arizona (23)

New Jersey (22)

Washington (22)