Upcoming ASC Legislation Adopts Elements of ACO Model, Hospital Value-Based Purchasing

Ambulatory Surgery Center Association representatives are drafting comprehensive legislation to resolve issues facing the ASC community and give patients better access to ASCs, according to an ASC Association release.

The proposed legislation would:

• Provide ASCs with an annual update based on the HOPD market basket rather than the CPI-U

• Place an ASC representative on the Advisory Panel on Ambulatory Payment Classification Groups, which reviews clinical integrity of APC groups and their associated weights, as well as makes recommendations to CMS on whether services can be safely performed in the outpatient setting

• Allow ASCs to provide CMS-required notifications about patient rights and other issues on the day of surgery

• Establish a quality reporting system based on the quality measures currently endorsed by the National Quality Forum and modify current law that allows CMS to develop measures without industry consensus

• Establish a value-based purchasing program to reward ASCs for providing high-quality care

The in-progress legislation adopts elements of the ACO model and the hospital VBP program to design a value-based purchasing program that would reward individual facilities based on quality performance. The program would also create an incentive for ASCs and the government to move clinically appropriate services out of the hospital outpatient department. As envisioned in the legislation, the VBP for ASCs would create a pool of money generated by savings to the Medicare program as surgery migrates from HOPDs. A portion of the savings would be returned to the Medicare system; the other potion would be set aside for bonus payments to ASCs that meet quality standards.

Read more about the ASC Association.

Read more about recent legislation:

-Legislation Introduced in New Jersey Concerning Licensure of Surgical Practices

-Nevada Transparency Bill May Improve Patient Safety

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