ASC industry leaders are urging Medicare to adopt a value-based purchasing system for ambulatory surgery centers that would reward facilities demonstrating high levels of quality and improvement in care.
The Patient Protection and Affordable Care Act signed by President Obama in the spring requires the Centers for Medicare and Medicaid Services to work with industry stakeholders and advise Congress on the development of a value-based purchasing (VBP) system for ASCs. In a letter to Health and Human Services Secretary Kathleen Sebelius this week, leaders of the ASC Advocacy Committee outline their recommendations for an incremental move from the current system to a VBP program for ASCs.
Some of their key recommendations:
Implementation should begin with voluntary data collection from facilities, followed by public disclosure of quality information.
Performance should first be measured within the ASC setting only, using quality indicators such as "efficiency, outcomes, patient experience of care, adherence to evidence-based processes."
CMS should then "develop and implement comparisons of the quality and costs for outpatient surgery in ASCs and hospital outpatient departments," allowing physicians and patients to make "apples to apples comparisons" between settings.
Payment differentials, in which payments are higher for high-performing facilities and those that have made significant quality improvements, "should be built upon a solid foundation of quality measurement."
Finally, CMS should develop a shared savings mechanism, in which "high-quality ASCs share some of the savings they have produced for the Medicare program," to help fund VBP bonuses.
"ASCs support a program that would create competition based on quality and efficiency, drive improvement in care, recognize the highest quality and most efficient facilities, and improve transparency across all outpatient surgery providers," says Andrew Hayek, chairman of the ASC Advocacy Committee and president and CEO of Surgical Care Affiliates, who signed the letter along with ASC Association Chairman David Shapiro, MD.
Irene Tsikitas
