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5 david shapiro-ambulatory-surgery-centers-in-usa_ncas_2011
1. Ambulatory Surgery Centers
in the
United States of America
David Shapiro, MD
National Conference on Ambulatory Surgery
Bangalore
2. ď Physician
ď Anesthesiologist (Specialization in Outpatient Anesthesia)
ď Florida Society of ASCs (FSASC) : Board Member
ď ASC Association (ASCA) : Chairman of the Board
ď ASC Quality Collaboration : Co -Chair
ď AAAHC : Surveyor
ď AORN ASC Administrator Course : Faculty
ď Certified Administrator Surgery Center (CASC) by the Board of Ambulatory Surgery
Certification
ď Certified in Health Care Quality and Management (CHCQM) by the American Board of
Quality Assurance & Utilization Review Physicians
ď Certified in Healthcare Compliance (CHC) by the American Hospital Association
ď Certified Professional in Healthcare Risk Management (CPHRM) by the Health Care
Compliance Board
ď Licensed in Healthcare Risk Management (LHRM) by the State of Florida
Dr. David Shapiro
3. ďźOpened February 12, 1970 in Phoenix, Arizona
ďźFounded by
Wally Reed, MD
John Ford, MD
ďźNamed âSurgicenterâ
ďźOriginally 4 ORs
ďźNow 6 ORs, 4 Endoscopy Suites
History of ASCs in the United States
4. First sketch of Surgicenter
made on the back of a tent
table ad at Smugglerâs Inn
in Chicago in 1968.
5. John L. Ford, MD and Wally Reed, MD in the OR on Surgicenterâs opening day, February 12, 1970.
6.
7. ASC Timeline
1968
Wallace Reed, MD, and John
Ford, MD, commit their idea for
a freestandingambulatory
surgery facility to paper for the
first time and develop
objectivesfor the facility. They
begin collecting endorsements
from the governmental bodies
and members of the health
care communityto obtain
financingfor the project.
1970
Reed and Fordâs idea becomes
reality when on February 12
Surgicenter,the nationâs first
freestandingambulatory
surgery facility, opens for
business.Five physicians
perform five procedures at the
facility that day, four requiring
general anesthesia.
1974
The Society of Freestanding
AmbulatorySurgicalCare
(ASCAâs original name) is
incorporatedduring an ASC
seminar conducted in
Phoenix, Arizona.
1975-1976
Rapid growth. A total of 42
surgery centers are in
operation in the US by 1975
and an additional 25
facilities open in 1976.
8. 1979
The industry continuesto
grow, with the number of
ASCs reachingtriple digits.
ASCA and others join together
to form the Accreditation
Association for Ambulatory
Health Care (AAAHC).
1982
Medicareapprovespayment
to ASCs for approximately200
procedures,which are placed
in one of four payment groups
with payment rates between
$231 and $336, based upon a
cost survey of 40 ASCs.
1987
Medicaremodifies the ASC
list to use specific CPT codes
and expands the list to
include1,535 procedures.
1988
The number of ASCs in the
US reaches1,000. Using the
information from a 1986
cost survey of ASCs,
Medicareimplementsa new
payment system, which
remains the basis for ASC
paymentstoday.
ASC Timeline
9. 1995
ASCs go internationalwhen
the InternationalAssociation
for AmbulatorySurgery
(IAAS) is founded during the
1st International Congresson
AmbulatorySurgery in
Brussels. Medicare expands
the ASC list to cover more
than 2,000 procedures.
2002
Seventy-eight individualsearn
the CASC credential,the first-
ever ASC-specific credential,
establishingthe ASC
administratoras a separate
and distinct career from other
health care management and
clinical positions.
2011
More than 5,300 ASCs exist
in the US today, performing
23 million surgeries
annually. Medicarehas
granted approval for ASCs
to perform more than
3,500 procedures.
ASC Timeline
18. ⢠Federal Regulation
Center for Medicare & Medicaid Services (CMS)
⢠State Regulation
Various State Health Department and/or Agencies
⢠Local Regulation
Primarily Building and Fire Code Compliance
Enforcement
ASC Regulation
19. Effective May 18, 2009 -
âmeans any distinct entity that operates
exclusively for the purpose of providing
surgical services to patients not requiring
hospitalization and in which the expected
duration of services would not exceed 24 hours
following an admission.â
42 CFR 416.2 DEFINITIONS
CMS: Definition of an ASC
20. ⢠Defines ASCs in Federal Law
⢠Determines Payment Policies
â Allowable Procedures
â Applicable Rates
â Annual Updates
⢠Determines ASCâs Participation in Federal Programs
â Conditions of Coverage
-Infection Control Checklist
⢠Administer Quality Reporting Programs
CMS
21. ASC Accreditation
ASCs are Accredited by 4 different Organizations:
Accreditation Association for Ambulatory Health Care (~3,010)
Joint Commission (~637)
American Association for Accreditation of Ambulatory Surgical
Facilities
American Osteopathic Association
As of Spring 2011: Over 70% of ASC facilities in the U.S.
are accredited by one of these four organizations
28. Impact
-8
-4
0
4
8
12
1998 2000 2002 2004 2006 2008 2010
Year-over-Year%Change
Growth in
Outpatient Surgery
0
2
4
6
8
10
12
1998 2000 2002 2004 2006 2008 2010
Year-over-Year%Change
Growth in
Number of ASCs
29. ASCs: The Innovative Solution for Health Care
Access
Convenience
Provision of Critical Services
Cost
Efficiency
Transparency
Quality
Clinical Outcomes
Patient Satisfaction
ASC Future
30. Ambulatory Surgery Centers
in the
United States of America
David Shapiro, MD
National Conference on Ambulatory Surgery
Bangalore