The Growth of Ambulatory Surgery Centers in Eye Care


Are you promoting the benefits to your patients and community?    

Most eye surgeries are now performed in ambulatory surgery centers (ASCs) rather than hospitals, a major shift that has occurred over the course of a decade. According to a study conducted by University of Michigan Kellogg Eye Center researchers, the proportion of cataract surgeries performed at ASCs increased steadily to reach 73 percent in 2014, compared to just over 43 percent in 2001.

“The increase in utilization occurred in many U.S. communities such that in some places nearly every cataract surgery took place in an ambulatory care center,” said senior author Joshua Stein, M.D. The increased use of ASCs also included cornea, glaucoma, retina, and strabismus surgery.

If you own, partner in, or operate in an ASC, here’s how to make sure that your patients—and your local community—are aware of the benefits and services ASCs offer.

Convenience and cost savings among reasons for ASCs’ growth

The Ambulatory Surgery Center Association (ASCA) defines ASCs as “modern health care facilities focused on providing same-day surgical care, including diagnostic and preventive procedures.” ASCA’s website states, “ASCs have transformed the outpatient experience for millions of Americans by providing them with a more convenient alternative to hospital-based outpatient procedures—and done so with a strong track record of quality care and positive patient outcomes.”

Convenience, proximity, and lower costs to patients and insurers are among the reasons for the increasing popularity of ambulatory surgery centers.

Patients may not understand what ASCs are or why they would choose this facility over a hospital, which may be better known and perceived as the superior option. Tell patients that benefits of ASCs compared to hospital-based care include:

Convenience. Not only do many patients live closer to an ASC than a hospital, but parking and scheduling are easier at ASCs, given that they are smaller and focused on specialty care. 

Lower health care costs. According to the Kellogg Eye Center study, surgeries performed at ASCs result in lower out-of-pocket costs for patients, and decreased cost-per-case for insurers. One analysis estimated that cataract surgeries performed at ASCs rather than hospitals saved Medicare $829 million in 2011. Patients save, too: the average cataract co-pay in 2014 was $190 compared to $350 at a hospital outpatient department.

Quality and safety. Emphasize to patients that ASCs are held to strict rules ensuring they maintain a sanitary environment to minimize infections and communicable diseases. “Because ASCs specialize in the procedures they perform, they are able to concentrate on patient safety and the patient experience and have an excellent record of safety and quality outcomes for patients,” noted the ASCA. 

Be aware, however, that among the most common citations against ASCs are those related to Quality Assurance Performance Improvement (QAPI) programs lacking required documentation, according to industry reports. 

Publicize your quality measures to promote your ASC to the public to show the level of care you provide and keep your ASC top of mind, suggested Becker’s ASC Review

Why eye care-focused ASCs are a ‘win’ for all involved

Ophthalmology comprises the biggest percentage of Medicare-certified single-specialty ASCs at over 26 percent, according to data from the Centers for Medicare & Medicaid Services (CMS). 

An ASC focused on the eye ensures that there are staff who are both interested and trained in ophthalmic surgery, said Robert Nelson, PA-C, executive director of Island Eye Surgicenter in Westbury, N.Y., in EyeWorld. Another thing your patients may not know is that many hospitals may not prioritize eye surgery because it’s considered less profitable than other specialties.

An efficient ASC can save surgeons hours per day and allow them to perform more surgeries. ASCs also gain access to new technologies more quickly.

ASCs are definitely a “win, win, win” for patients, for health care, and for eye surgeons, according to Bradley Black, M.D., in the Ophthalmology Times. Conveniences such as easier, more flexible scheduling benefit both patients and surgeons. An efficient ASC “can save a moderately busy surgeon hours and hours each week, freeing them up for more time in the office or elsewhere,” said Dr. Black. “Time is our most valuable commodity.” Richard G. Davis, M.D., told EyeWorld that he does four cataract surgeries per hour at the ASC where he is a founding partner versus only 1.5 per hour with a local hospital system.

Another way to promote your ASC to patients is to let them know that ASCs are more likely to have the latest technologies. “Compared to a large multispecialty hospital with many layers of bureaucracy and the many different players involved in the decision, a smaller and more focused ASC typically can gain access to newer technologies more quickly,” said Y. Ralph Chu, M.D., in EyeWorld. He gave the example of femtosecond lasers, noting that ophthalmic-specific ASCs were among the first in the U.S. to have access to these. 

Jerome Levy, M.D., also noted that this affects staffing. “The need for new technology is essential in order to recruit the younger and better surgeons,” he said. 

For more on this topic, download Rendia’s eBook, Top Secrets to Hiring, Training, & Retaining an All-Star Medical Staff.

ASCs are also more likely to use more advanced methods of patient education. Remember, patient education should include caregivers and family members, too. With the right technology and video content, you can use screens in your waiting area to help them understand normal post-operative symptoms, care, and recovery, while also highlighting how cataract surgery improves quality of life in case anyone in the patient’s family is considering it. 

Rendia offers comprehensive pre- and post-op videos to educate patients about surgery and reduce their anxiety about the process. To see how some of our practices use this content with cataract patients, download our video guide, Advance Your Status as a Top Cataract Surgeon.

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