For most of the last decade, ASC quality reporting has been a compliance exercise through data submitted to CMS to avoid a payment penalty.
That is changing quickly. In 2026, the Leapfrog Group rolled out the first public, facility-level grading program for ASCs, layering a consumer-facing scorecard onto a CMS reporting structure that is itself shifting toward mandatory, patient-reported outcome measures.
For ASC leaders, numbers that used to live in a compliance spreadsheet are becoming a public rating patients, payers and referral sources can search.
Leapfrog has surveyed ASCs since 2019, but participation was voluntary and, for years, the payoff was a private benchmarking report rather than a public score.
That changed April 1, when Leapfrog announced a major expansion of its ASC public reporting program: nearly 4,000 ASCs would be scored on 13 CMS quality and safety measures, with five more metrics credited to centers that submit proof of accreditation, using a revised “ASC Survey 2.0” covering patient rights, health equity, “never” events and safety practices.
In practice, most centers got only the baseline CMS-measure score. Of the roughly 3,900 ASCs Leapfrog reported on, about 300 also submitted the ASC Survey, an accreditation certificate or both, Leapfrog CEO Leah Binder told Becker’s. Public, facility-level data went live in July 2026.
When Leapfrog published its full 2026 results July 27, it reported record participation and introduced a “Full Transparency Badge” for centers that completed every section of the survey.
“Ambulatory surgery centers account for the majority of surgeries in the United States, yet patients have historically had limited information about their safety and quality,” Missy Danforth, Leapfrog’s senior vice president of healthcare ratings, said in a news release.
“Transparency is now the norm in American healthcare — and declining to be transparent is the exception,” Leapfrog CEO Leah Binder told Becker’s.
ASC administrators who took Leapfrog’s 2019 survey were openly skeptical of what that transparency actually measures. Critics argued the expert panel that built the questions was drawn from hospital-based physicians and nurse organizations — including UPMC and Johns Hopkins leaders — with no one holding an ASC-specific title. Michael McClain, executive director of ASCs at Renton, Wash.-based Providence St. Joseph Health, called the survey “incredibly acute care-centered,” reflecting hospital norms rather than ASC practice.
Others objected to specific asks, such as antimicrobial stewardship requirements that go beyond regulation and, they argued, beyond the evidence base for outpatient surgery.
None of this happens in isolation from CMS’ own Ambulatory Surgical Center Quality Reporting Program, which already ties data submission to payment. That program is actually trimming its measure set for now, not expanding it. CMS’ calendar year 2026 final rule removed the Facility Commitment to Health Equity measure, two social-drivers-of-health screening measures and the COVID-19 vaccination measure, citing limited value and administrative burden.
On the outcomes side, ASCs are already phasing in a hip-and-knee-replacement patient-reported outcome-based performance measure — finalized back in the 2024 rule, with voluntary reporting through 2027 and mandatory reporting, tied to payment, starting in 2028.
A second, broader measure capturing patients’ understanding of post-procedure recovery information was proposed on a similar track, voluntary in 2027-2028, mandatory by 2029, but CMS declined to finalize it in the 2026 rule, citing survey-design and burden concerns, while signaling it isn’t done with the idea.
Taken together with Leapfrog’s expansion, ASCs are heading toward two differently paced, increasingly public accountability tracks: a mandatory, payment-linked program that just got smaller even as its outcome measures phase in, and a voluntary scorecard that just got bigger and more visible by name.
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.
