Medicare's ASC Quality Reporting (ASCQR) program is nothing new: Ambulatory surgery centers have been reporting quality information, such as the rate of patient safety incidents, since 2014, with results first publicly reported in 2017. But looking forward, things are likely to change: while CMS has proposed delaying mandatory reporting of the five quality measures that are derived from the Outpatient and Ambulatory Surgery CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey indefinitely, ASCs will likely be on the hook for consumer experience in the future.
Consumer experience does not equal patient satisfaction
ASCs have long understood the importance of patient feedback: More than 99.5% of ASCs use patient satisfaction surveys. But research shows that patient satisfaction rarely varies across practices; unlike consumer experience, which measures discrete occurrences.
That's exactly what the CAHPS survey seeks to measure: information about actual consumer experiences. Therefore, an ASC that has achieved high patient satisfaction in the past isn't guaranteed to perform well on the new CAHPS survey. ASCs should be vigilant in understanding their performance across both patient satisfaction and consumer experience metrics.
Given an industry-wide shift toward value-based care, ASCs may eventually be subjected to pay-for-performance based on their consumer experience outcomes, in addition to traditional quality measures. And in the long-term, experience scores might be used as an additional measure when comparing ASC to hospital outpatient department (HOPD) quality measures as CMS determines its regulatory and reimbursement approach toward both sites. Therefore, ASCs that can master consumer experience will likely have an advantage when competing for consumer business and CMS's rewards.
Focus on consumer preferences today in preparation for possible pay implications tomorrow
Regardless of Medicare's pay-for-performance plans, it is important for ASCs to appeal to consumers, many of whom self-refer for certain elective surgeries.
For these self-referring patients, things like cost and travel time matter greatly. Our Surgical Care Consumer Survey showed that most patients—even the wealthy—shop primarily on the basis of cost when choosing their surgery provider. Most will even drive four hours or fly three hours if it meant saving $2,000 on their surgery. ASCs should focus on these consumer preferences as well as those measured specifically by the new mandate, such as wait times, in order to improve their consumer focus and standing under CMS's CAHPS program.
A previous version of this blog was posted based on CMS's 2017 OPPS/ASC final rule. The recently released Proposed Rule for CY 2018 has proposed delaying ASC Quality Reporting. The blog has been updated to reflect this new proposal.