Leapfrog Group’s new ASC Public Reporting Program ran into an obstacle hospitals rarely face: a meaningful share of ASCs still don’t have the systems in place to track their own quality data.
“We found that ASCs have many more barriers to reporting than hospitals do,” Leapfrog Group President and CEO Leah Binder told Becker’s, “because so many ASCs are reliant still on paper records or [have] electronic systems [that] are not as sophisticated as what hospitals have. That makes it more difficult for them to track important quality data.”
According to the Ambulatory Surgery Center Association’s July 2025 survey, 76% of ASCs now use an EHR. This is the highest share since ASCA began tracking the measure in 2021, up from 55% that year, but the remaining holdouts show little urgency to change. Sixty-eight percent of ASCs without an EHR said they plan to stick with paper charts until forced to switch, up from 59% in 2023. Cost was the top barrier cited (49%), followed by the belief that an EHR isn’t necessary (15%) and staff resistance (12%).
“EHR interoperability between ASC, hospital and physicians office has a long way to go. Coordinating care should be seamless between agreeable parties,” Jeffrey Carlson, MD, president of Newport News, Va.-based Orthopaedic & Spine Center, told Becker’s. “All too often hospital-owned ASCs will want to have every physician office use the hospital-owned EHR. Unfortunately, hospital EHRs are too cumbersome for ASC efficiency and too expensive for physician offices. For surgeons to place patients on the operative schedule, it may require entering three EHRs with different passwords and different hard stops programmed into their system. This is time consuming and may lead to more errors — certainly not the sleek experience we want to have at an ASC.”
Even for ASCs with modern systems, staffing is a separate hurdle. Unlike hospitals, most centers don’t have anyone whose job is specifically to handle quality reporting.
“They typically don’t have one person whose entire job [is] quality reporting to all the entities,” Ms. Binder said. “They report to health plans and Medicare… but they typically don’t have one person whose job is to do that, and so it’s kind of something they all do on the side. It makes it very, very burdensome for them to report additional quality information.”
But Ms. Binder said quality should be the biggest focus of ASCs.
“Quality should be at the center of anything that an ASC is doing,” she said. “But that’s not always the way ASCs are structured, and quality is difficult for them to keep up with.”
To lower that bar, Leapfrog built its ASC survey to take less time than the hospital version and layered in two data sources that require little extra effort: CMS measures ASCs already report on a mandatory basis, and credit for centers that submit proof of accreditation from one of two accrediting bodies.
“That is the amount of time it takes to fax a one-page document — that’s all the effort it requires,” Ms. Binder said. “We’ve been able to reduce the amount of work that an ASC has to do in order to publicly report to their community.”
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
