ASCs are 'anxious to show their value': Leapfrog CEO explains decision to lift survey cap

The Leapfrog Group lifted the participation cap on its first-ever ASC safety and quality survey in January, opening participation to all licensed ASCs in the U.S. Leapfrog President and CEO Leah Binder spoke to Becker's ASC Review about the decision and what ASCs interested in participating should know.

Note: Responses are lightly edited for style and clarity.

Question: What made you decide to lift the participation cap of 250 ASCs?

Leah Binder: We have not opened the survey, so we don't have any numbers yet, but what we have are indications from so many ASCs that they planned to participate in the new survey when it launches April 1 that it was clear we were going to reach the cap instantly. We [received] endless phone calls from ASCs wanting to make sure they were in that initial launch, so it became clear we needed to open it up.

They contacted us and expressed their decision that they would be participating and asked if they could be officially signed in to participate, which we don't have a process for. We just told them to register after April 1.

Q: What does the overwhelming response from ASCs indicate to you about the space?

LB: That ASCs are transparent, competitive and good businesspeople. We're very impressed with their interest in competing in an open and transparent marketplace. It's clear that ASCs are willing and able and anxious to show their value in the open marketplace, and that is a good sign that they are transparent. It's also a good sign that they are delivering a high-quality product — we'll see. We'll look at the numbers when they come in, but it's certainly promising that they're so excited about the opportunity to have their quality publicly reported.

For a very long time, we've known virtually nothing about the quality of ASCs, and that's frustrating to ASCs as well. When you're delivering an excellent service, you want people to know it, and you want to be rewarded for that in the marketplace. That's what Leapfrog is about: creating an open and transparent environment for the best providers to accomplish the most in the market.

Q: What other feedback have you gotten since announcing the survey?

LB: There's certainly some questions about what we plan to include in the survey, although we're still working out the final details. We've been actually finding the feedback from ASCs very helpful to us as we shape the final survey.

Q: What kind of feedback has been the most helpful?

LB: One of the issues is ensuring that it's feasible for most ASCs to complete the survey. ASCs may not have the sophistication in their medical records that allows them to easily complete some of the questions, and sometimes, they just have a different approach to staffing, quality and structure that we need to be aware of. We're used to the staffing and structure that hospitals have, since we've been reporting on hospital performance for almost 20 years, but we're learning more about the protocols and structures that are the norm for ASCs. We want to be aware of what ASCs typically do so that we are setting standards that make sense.

Q: Has Leapfrog made any other significant changes since the initial details of the survey were released?

LB: We've adjusted some of the wording of some of the questions, but nothing yet has been a significant change from how we outlined the survey back in the fall.

We're testing the ASC survey, have received a significant amount of feedback from individual ASCs [and] ASC organizations, and we're using that to frame the first survey. We anticipate learning even more once we launch and receive completed surveys. Every year, we revisit all of our surveys, including our hospital survey. We revisit the literature and the research around quality and safety, and we sometimes add new questions, change questions or change elements of the survey to better reflect the industry norms and best practice literature.

Q: Is there anything else you'd like ASCs to know?

LB: We do want to encourage all ASCs to register with [the National Healthcare Safety Network] through the CDC. It's a process, but it's a way for them to report their infections officially to the CDC, and then Leapfrog will be collecting that data as well through the CDC, and they can authorize that. Any ASC can register. If an ASC does not have Medicare certification, they will need to register with NHSN in order to get into our survey. It's something they can start the process of now. There's some issues some ASCs may have with that process, but it's really the best process available to ensure we are getting the right authorized people responding to our survey and that we're getting the best possible infection data.

ASCs can find instructions on how to register with NHSN here.

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