Digital Debut

ASCQC Conference Shows Industry’s Continued Commitment to Quality

Federal officials provide updates on government quality initiatives

BY ALEX TAIRA | JULY 2019

On July 22, the Ambulatory Surgery Center Quality Collaboration (ASCQC) held its sixth annual conference in Washington, DC. The meeting brought together a wide-ranging group of industry stakeholders, including representatives from facilities, physician groups, management companies, health information technology (IT) vendors, regulatory agencies, specialty societies, accreditation and quality organizations. The diverse attendee group reflects the industry’s collaborative commitment to maintaining high quality of care in ASCs across the country. Perhaps even more importantly, the willingness of many attendees to continue attending year after year, coupled with the addition of new stakeholders—2018 was the first ASCQC conference to include vendors—shows an understanding that commitment to quality is an ongoing process. By voluntarily continuing to share best practices, discuss areas for improvement and review ever-expanding quality benchmarks, ASCs can maintain their place as high-quality, low-cost centers for care.

Within the full afternoon agenda, presenters provided updates on several federal government quality initiatives in the ASC space. First, David Pollock, MD, surveillance branch chief for the Centers for Disease Control and Prevention’s (CDC) Division of Healthcare Quality Promotion (DHQP) presented on the new CDC protocols regarding surveillance for surgical site infections (SSI). In January 2019, the CDC issued new guidance for ASCs that moved SSI surveillance under the Outpatient Procedure Component (OPC) of the National Health Safety Network (NHSN). SSI account for estimated annual cost of $3.3 billion and 1 million additional inpatient days according to the CDC. A handful of states—Colorado, Nevada, New Hampshire, New Jersey, and Texas—currently require SSI reporting. These states must report data manually via the NHSN web portal, but Pollock mentioned that CDC hopes to move to electronic health record (EHR) upload reporting if health IT continues to expand in the ASC space.

Missy Danforth, vice president of Health Care Ratings at the Leapfrog Group delivered another notable presentation. Beginning this year, Leapfrog began collecting data for an ASC survey on patient safety and quality, a product that the large employers that support Leapfrog have been asking the group to design. In addition, Leapfrog has added an outpatient component to its well-known long-running survey on patient safety and quality in hospitals. In the hospital product, grades are assigned—“A to “F”—to facilities based on survey results. The new survey, however, is a separate product and ASCs will not be assigned grades at this time. Any ASC that does choose to respond to the survey in 2019 will not have any of its information made available to the public but will receive a free benchmarking report for its own review. Danforth announced that 2020 is the first year that Leapfrog plans to make survey results publicly available. For more information on Leapfrog Group’s ASC Survey, read a Q&A with ASCA Chief Executive Officer Bill Prentice.

ASCQC Executive Director Donna Slosburg provided an update on the Outpatient and Ambulatory Surgery Survey Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey. CMS and RTI International, an independent non-profit institute that specializes in research and quality measure development, developed this 37-question survey from 2012 to 2015. The survey measures the experience of care for patients who have a surgery or procedure in a hospital outpatient department (HOPD) or ASC. It was initially finalized for inclusion in the ASC Quality Reporting Program but in the calendar year (CY) 2018 OPPS/ASC Final Rule, CMS ultimately delayed mandatory implementation due to industry concerns over burden related to administering the survey. CMS had approved survey administration by telephone, mailed survey, and mail with a telephone follow-up, but there is currently no electronic option.

To address these concerns, CMS is administering a web-mode experiment. Between January and September 2019, CMS is collecting data to assess the impact of adding new survey administration modes, including web submission, web with mail follow-up and web with a telephone follow-up. The experiment is not expected to impact the CY 2020 ASC Payment Rule but the results will be considered for future rulemaking. There are currently 3,143 facilities that have registered for OAS CAHPS; 1,161 ASCs and 1,982 HOPDs. Of those, 92 percent utilize the mail mode and 8 percent utilize the phone mode. Participating facilities may choose to make their data public and the publicly available data shows high scores among participating facilities. The first publicly available data was posted in April 2018, and the information is currently being updated quarterly.

The ASCQC website provides regularly updated quality data submitted voluntarily by more than 1,500 ASCs. The ASCA website provides up-to-date information on ASC quality reporting requirements. For more information write Alex Taira.