Last year, CMS approved more than 500 procedures for the outpatient setting, representing a huge win for the leaders and physicians in the ASC industry who have advocated for an expanded ASC covered procedures list for years.
The win came from years of concerted effort and advocacy on the part of the Ambulatory Surgery Center Association, professional physician and specialty societies and other stakeholders — all working together to overcome significant barriers to data collection and analysis in the ASC space.
“We had a spine surgeon in the ASC space who was able to perform a lot of the lumbar fusion codes during the COVID-19 pandemic when CMS created a Hospital Without Walls Program, as that allowed ASCs to expand upon what they could do,” Kara Newbury, chief advocacy officer for ASCA, told Becker’s. But having this kind of facility-level data on the Medicare population in the ASC industry is difficult to come by — in part because about 30% ASCs still rely on paper charting, making data collection far less efficient.
Laura Ishii, MD, interim president of Johns Hopkins Bayview Medical Center and senior vice president of operations for Johns Hopkins Health System in Baltimore, told Becker’s that, as an academic medical center, data collection is embedded in their ASC operations.
“That’s part of our DNA, the tripartite mission-excellent clinical care, education and research,” she said. “We encourage our faculty members to use ASCs as a data collection point. If your area of focus for research is joint replacement surgery, and the majority of your joint replacement surgeries have moved to an ASC, then you need to be collecting your clinical data in an ASC.”
Dr. Ishii said that in acknowledging that ASCs are the go-to site of service for an increasing number of procedures, Johns Hopkins also recognizes the need to shift clinician training to reflect the reality of the outpatient migration.
“If you have moved those procedures out of the hospital and they’re now in an ASC, then learners need to be in an ASC,” she said. “You’re educating the pipeline for future generations, be they physicians or nurses or sterile processing technicians.”
Within Johns Hopkins’ network there are seven ASCs, all of which operate under a single limited liability corporation, Dr. Ishii said. Two are designated as joint replacement sites, while another two operate as cardiology hubs. Dr. Ishii said that this strategic utilization of ASCs allows them to keep programs and staff highly specialized and efficient.
“I think for us, because we are a mission-driven organization focused on the tripartite mission, I think we can think of our ASCs as sites for the tripartite mission, which lets us do really cool things that we would otherwise be able to do,” she said.
