Assessing Ambulatory Service Centers
Covert says that the new rule could potentially make hospitals' outcomes look better but make ASCs' outcomes look worse, but "that is why we have tight preoperative screening processes in place to uphold managing the right patient in the right venue."
The new rule will ultimately help ASCs and patients by separating the good from the "not-so-good," Priest says.
"If you have a surgery, your goal is to get home," Priest says. "Our burden is to try to minimize the time [patients] spend in the hospital, if we can do it safely. This rule will also allow us to create an infrastructure in those environments that will allow us to take care of sicker patients."
Of course, ASCs could opt to not report their quality metrics and take the 2% payment reduction, but it does not seem likely.
"Margins are very tight in our industry, so I find it hard to believe that an organization would forgo that payment," Covert says. "Having noted that, there are many small, standalone organizations that are going to find themselves conducting business in a new way and holding themselves to a higher standard. It will be a steep learning curve for the smaller players."
In addition to a payment cut, ASCs that choose not to report will risk being vilified by competing organizations for their lack of transparency. While reporting organizations risk looking inferior to the surgery center down the road with better quality scores, it fosters an environment of positive competition that will benefit patients.
"It's pretty hard to not be willing to tell people whether you have wrong-site surgeries because I'm walking into your ASC with my iPad and looking up data on everybody—including you," Priest says. "It changes the game."
All in all, the new reporting measures will help surgical centers create systems and processes that measure other quality metrics.
"It will improve patient care and attract patients to Bon Secours and attract physicians and nurses that want to improve patient care," Priest says. "The measures are a good place to start. It's something the public deserves. We don't need to be shrouded in secrecy, and the more transparent we are, the more we're able to solve our challenges, so I'm pretty upbeat about it."
This article appears in the June 2012 issue of HealthLeaders magazine.
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