Elevate Your ASC’s Bottom Line With Quality Reporting

Ambulatory Surgical Centers (ASCs) have emerged as a cornerstone of modern patient care, offering a convenient, cost-effective alternative to hospital-based surgeries. With over 6,200 ASCs in the United States performing millions of procedures annually, their role in the healthcare system is undeniable.

ASCs account for more than 40% of all surgeries and are a massive part of today’s healthcare delivery chain. As reimbursements struggle to keep up with surgical costs, that number will likely increase as more hospital outpatient departments transition into ASCs. With that growth comes risk. Patient outcomes are always under the microscope, and as Medicare reimbursements are increasingly tied to performance on quality measures, they’re more important than ever. The Ambulatory Surgical Center Quality Reporting (ASCQR) Program has emerged as a vital pillar for supporting excellence and continuous quality improvement in patient care and safety.

However, the ASCQR Program is more than a regulatory mandate. It’s also a strategic opportunity for ASC facilities wanting to advance in a competitive healthcare market. This article will explore the ASCQR Program’s purpose and why it’s vital for your facility’s bottom line.

Understanding the ASCQR Program

The ASCQR Program requires ASCs to report specific measures related to patient outcomes, safety, and experiences. CMS aims to hold ASCs accountable for providing care that meets the safety and quality standards expected in hospital outpatient departments (HOPDs).

Specifically, the ASCQR Program seeks to enhance the quality of care provided in ASCs by improving patient care and outcomes and increasing transparency and accountability. Through the program, CMS also pushes ASCs toward value-based care models that reward ASCs in accordance with the quality and efficiency they provide patients.

So, why does the ASCQR Program matter for your ASC? It comes down to your bottom line. Facilities that fail to meet the program’s reporting requirements may be ineligible for full medicare reimbursements. Your facility could see a 2% payment penalty applied to your annual payment rate update. With Medicare reimbursements struggling to keep up with the costs of supplies and operations, it’s a penalty that most ASCs can scarcely afford.

ASCQR Reporting Requirements

To ensure comprehensive quality reporting and improvement, CMS’ ASCQR Program has specific reporting requirements for ASCs. These measures are categorized based on the submission method and focus on various patient care and safety aspects.

Adhering to these ASCQR reporting requirements is crucial for staying compliant and enhancing your facility’s patient outcomes.

Measures Submitted via HQR

  • Patient Burn
  • Patient Fall
  • Wrong Site, Wrong Side, Wrong Patient, Wrong Procedure, Wrong Implant
  • Appropriate Follow-Up Interval for Normal Colonoscopy in Average-Risk Patients
  • Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery*
  • Normothermia
  • Unplanned Anterior Vitrectomy

*Note that your ASC can voluntarily submit data for cataract treatments but will not be subject to a payment reduction for this measure during the voluntary reporting period.

Measures Submitted via NHSN

  • COVID-19 Vaccination Coverage Among Health Care Personnel

Outcome Claims-Based Measures

  • Facility 7-Day Risk-Standardized Hospital Visit Rate after Outpatient Colonoscopy
  • Hospital Visits after Orthopedic Ambulatory Surgical Center (ASC) Procedures
  • Hospital Visits after Urology Ambulatory Surgical Center Procedures
  • Facility-Level 7-Day Hospital Visits after General Surgery Procedures Performed at Ambulatory Surgical Centers

These outcome-based measures are calculated from your facility’s paid Medicare fee-for-service claims, so your ASC doesn’t have additional data submission requirements for these measures.

Why the ASCQR Matters for Quality Improvement

The ASCQR may seem like one more tedious regulatory requirement. However, it’s a powerful tool for driving quality improvements and patient outcomes in your facility. Utilizing the data you report to drive change can ultimately lead to better patient experiences and better experiences are tied to a better bottom line.

For example, if your ASC sees a higher-than-average rate of patient falls, it could indicate a need for more thorough pre-operative assessments or staff training on patient mobility. Likewise, tracking outcomes such as normothermia rates post-surgery can help facilities refine their patient warming protocols, reducing the risk of complications and improving recovery times.

Leaders Must Drive Improvements

While your facility’s ASCQR data can drive quality improvements, it won’t create change without the backing of your ASC’s physician and surgeon leaders. Culture starts at the top, so your leaders are ultimately responsible for demonstrating their commitment to continuous improvement and patient safety.

Your facility’s leaders can foster a culture of quality by regularly reviewing ASCQR data with their teams, celebrating improvements, and setting goals for quality metrics. Leaders must cultivate buy-in and support from staff at all clinical and administrative levels. Significant advancements in patient care can be achieved if staff feel empowered to contribute ideas for quality enhancement and when transparent discussions about areas for improvement are the norm.

How to Reduce the ASCQR Program’s Burden and Use Data to Your Advantage

The ASCQR is crucial for your facility, patients, and the ASC industry. However, it does come at a cost. Data collection processes, analysis, and reporting infrastructure all take resources — and time. To minimize the ASCQR Program’s impact on your facility’s budget, consider the following tips:

Technology is Your Friend

Streamline your data collection and reporting obligations by using tech that integrates with your EHR, reduces the need for manual data entry, and minimizes errors.

Invest in Staff Training

When your team accurately captures data at the right time, it reduces the time needed to make corrections later. That saves your facility time, and time is money.

While the time and resources needed to collect data for the ASCQR can sometimes be a burden, it’s also a tool that can give your facility a competitive edge and support your marketing efforts.

Highlight Your Facility’s Quality Achievements

Using your ASC’s performance data in marketing materials can highlight your commitment to quality and safety. For example, if your ASC has consistently high scores in patient safety measures, make this a focal point in patient brochures and on your website.

As patients become more aware of varying quality between facilities and healthcare organizations, transparently showcasing your quality can build trust. Quality care will become even more important as patients’ responsibility for healthcare costs increase.

Own Payor Negotiations

If there’s one through-line for the ASCQR, it’s that it will ultimately impact your bottom line. It’s up to your facility and its leadership to determine the impact. High-quality and constantly improving patient outcomes can be a bargaining chip when negotiating better reimbursement rates with payors.

Attract and Retain Top Talent in a Competitive Labor Market

ASCs are talent magnets, providing unique benefits to the team’s clinical, financial, and administrative parts. The healthcare industry is struggling to find sustainable staffing solutions, and employers need to differentiate their opportunities.  Strong quality scores are a differentiator – top candidates want to work in organizations that reflect well on them.

If your ASC’s quality showcases a culture of excellence, dedication, and continuous improvement, it’s just one more point in your facility’s favor to attract and retain strong staff.

Get Prepared For The Future With The Guidance of an ASC Expert

CMS regularly updates the ASCQR Program to reflect advances in healthcare practices, policy changes, and stakeholder feedback. To stay informed and compliant with the ASCQR Program’s requirements, monitor the CMS’ website for updates and tap your professional network to learn how other facilities adapt to changing reporting requirements and stay compliant.

Although monitoring for changes can keep you compliant, adopting a proactive approach to quality reporting can foster a culture of continuous quality improvement and innovation.

For ASCs, new and long-established, the ASCQR program poses challenges. Navigating the complex reporting requirements can drain time and resources while exposing you to reimbursement risks. If you’re establishing an ASC or are struggling to build a culture around continuous quality improvement, an ASC consultant can drive your facility forward.

Sullivan Healthcare Consulting’s team of ASC consultants have been helping organizations manage to higher operating margins for over 30 years. Our consultants’ operational assessments can identify the areas ripe for improvement, and their experience at the forefront of the ambulatory surgery industry provides them with the know-how to implement sustainable solutions.

If your ASC needs guidance with quality improvement or the ASCQR Program, get in touch with Sullivan’s experts today.

Let’s Connect Today

5 + 13 =

Complete equation to submit