One accreditation official points to more than $180,000 in savings potential when discussing energy, waste and anesthetic costs many ASCs treat as fixed overhead.
A team affiliated with Boston-based Harvard Medical School is aiming to change the infrastructure that governs ASC sustainability, embedding a certification directly into the accreditation surveys facilities already undergo.
According to a July 2026 white paper shared with Becker’s, the GreenCare ASC Sustainability Certification Program is designed to be adopted by accreditation organizations — the AAAHC, The Joint Commission, the ACHC — and integrated into the survey processes ASCs already undergo. Rather than creating a parallel inspection system, the program, which was developed through the Climate Health Organizing Fellowship at Cambridge Health Alliance, layers onto existing credentialing infrastructure to reach thousands of facilities without requiring each one to be individually persuaded.
“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.”
The certification is offered to accreditation organizations on a non-exclusive basis, meaning any adopting body can incorporate the framework under its own branding and integrate evidence review into its established survey process. The design is deliberately accreditation-agnostic, with the goal of a credential that functions consistently regardless of which body a facility uses.
The framework comprises six documents: a universal Foundational Credential that applies to every ASC regardless of specialty, and five specialty pathways covering multispecialty, gastroenterology, ophthalmology, orthopedic surgery and pain management and plastic surgery. To earn the Foundational Credential, a facility must implement qualifying measures across six key performance areas: energy, waste, procurement, pharmaceutical stewardship, water and anesthetic gas stewardship.
Howard Maunus, MD, a retired gastroenterologist and lead author of the program, told Becker’s the accreditation lever was chosen deliberately. Rather than relying on facility-by-facility advocacy, embedding sustainability into the credentialing ecosystem reaches the industry at scale through infrastructure it already trusts.
The certification uses two evidentiary levels. Provisional status reflects documented adoption of qualifying practices. Verified status requires baseline data and supporting evidence reviewed through on-site assessment, virtual document review with photographic verification or integration into an accreditor’s existing survey process.
Accreditation organizations already emphasize organizational leadership, documented policies, evidence review, quality improvement and continuing readiness, which are the same dimensions around which GreenCare is built. The program is designed to add a sustainability layer to those existing processes rather than require a new compliance pathway.
Whether any major accreditation body will formally adopt the framework is still to be determined. The white paper notes that the certification has been discussed with national accreditation organizations and is available for adoption. Pilot results from three facility assessments, with modeled savings ranging from $55,000 to $656,000 per facility per year, are being prepared for peer-reviewed publication to strengthen the evidence base before broad accreditor adoption.
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.