A team from Boston-based Harvard Medical School is piloting what may become the ASC industry’s first comprehensive sustainability certification, aiming to demonstrate that environmental initiatives can also generate meaningful cost savings.
The program, called the GreenCare ASC Certification, was developed by Harvard Medical School’s Climate Health Organizing Fellowship. The framework includes a 1,000-point certification system measuring performance across five key areas: energy, waste, water, anesthetic gas management and sustainable procurement.
The team has launched a pilot project at Bergen-Passaic Cataract Surgery and Laser Center in Fair Lawn, N.J., an ophthalmology-focused ASC. The pilot will run through June 2026 and evaluate the financial and environmental impact of a series of sustainability interventions.
“We didn’t want to create a certification that was purely environmental,” said Howard Maunus, MD, a retired gastroenterologist and fellowship participant who helped lead the initiative. “Everyone we spoke to in healthcare sustainability emphasized that it wouldn’t go anywhere unless we tied it into financial savings.”
The project was developed with guidance from 22 healthcare sustainability experts and organizations including EyeSustain, the American College of Surgeons’ Sustain program, the Association of Perioperative Nurses, Practice Greenhealth and the Medical Society Consortium on Climate and Health.
ASC leaders are currently focused on workforce shortages, reimbursement pressure and payer negotiations, which can make sustainability initiatives a lower priority. Dr. Maunus told Becker’s the program was designed with those realities in mind.
“I spent 30 years working in outpatient ambulatory surgery centers,” he said. “At monthly meetings the first question was always about financial distributions. So we knew sustainability had to demonstrate real cost savings.”
The New Jersey pilot is expected to generate $90,000 to $180,000 in potential annual savings, according to project estimates.
Energy efficiency improvements alone, including LED lighting conversions, occupancy sensors and HVAC optimization, could reduce electricity costs by 5% to 10%, or roughly $10,800 to $21,600 annually based on the facility’s current energy spending.
“There’s a perception that facilities take it for granted that there’s not much they can do with utility costs, waste costs, anesthetic costs — that it’s just the cost of doing business, and they don’t have a lot of control over it,” Richard Parker, associate director of life safety and physical environment at the Accreditation Commission for Health Care, told Becker’s. “It’s a missed opportunity, because they’re leaving money on the table. If they can reduce and control those expenses more effectively, it’s going to provide either the same level or better care for patients and free up capital or funding for new equipment, customer service — any touch points that make the customer experience better.”
The pilot also evaluates clinical and operational technologies intended to reduce waste and supply costs, including DropMate sterilization systems for multi-dose eye-drop bottle reuse and NanoDropper technology that reduces eye-drop volume by up to 60%
The pilot is being implemented with support from SION60 ASC, a consulting firm focused on ASC decarbonization and operational efficiency. The firm will measure greenhouse gas reductions and financial outcomes, including changes in energy use and waste generation.
According to Dr. Maunus, gathering this data is a critical step in convincing large ASC operators to adopt sustainability initiatives.
“When we talk to large ownership groups like USPI or SCA Health, the first question they ask is: ‘Show us the data,’” he said. “But you can’t get the data until someone is willing to run the pilot.”
If the pilot demonstrates measurable savings, Dr. Maunus believes large ASC operators could scale the model across their portfolios.
“If a company that owns hundreds of surgery centers sees that each one can save even $10,000 or $20,000 a year, that becomes a significant financial incentive,” he said.
The certification program has already drawn interest from accreditation bodies and healthcare organizations exploring ways to incorporate sustainability into ASC operations.
Pilot results, including cost savings and greenhouse gas reductions, are expected by mid-2026, and the team plans to present findings at CleanMed and pursue publication in peer-reviewed journals.
For ASCs under growing financial pressure, the initiative could provide a framework for improving both operational efficiency and environmental performance.
