For more than 40 years, ophthalmic procedures have been performed in the ambulatory surgery center (ASC). Today, more than 75 percent of cataract procedures are completed in ASCs, with most of the rest being done in hospitals. Thanks to many years of successful advocacy in Washington, D.C., virtually all ophthalmic procedures are now approved, regulated, and supported with payer reimbursement in the ASC.
Performing ophthalmic surgeries in an ASC has been instrumental for surgeons committed to the highest standard of care, innovation, and their financial investments. The many significant benefits of the ophthalmic ASC deserve to be touted:
Patient Safety: Ophthalmic ASCs are designed specifically for outpatient procedures, which means they are equipped with the necessary resources and expertise to handle surgeries efficiently and safely. Patients benefit from the focused attention and specialized care provided in these centers, resulting in the best outcomes. Federal ASC regulations and oversight, as well as accreditation, ensure that the standard of care is never compromised.
Cost Efficiency: ASCs are typically the most cost-effective location for ophthalmic surgeries. Resources and processes are streamlined and efficient, and overhead costs are controlled, leading to reduced expenses for both patients and insurance payers. This cost efficiency is important to the Centers for Medicare and Medicaid Services as well as to health insurance companies, as it helps contain healthcare expenditures without compromising the quality of care.
Convenience and Accessibility: ASCs are generally convenient for patients and their caregivers. They are often located in same building as the physician’s office, or else nearby in the communities they serve. They are generally designed with an easy-to-navigate footprint. Most ASCs have integrated communication and operational processes, streamlining and enhancing the overall patient experience.
Ownership Value: Physician ownership of ASCs allows for greater control over decision-making processes as well as solid financial returns. Most physicians say the highest performing investment in their portfolio is their ASC. Another proof-point of the value of the surgery center as an asset is how attractive ASCs are to private equity investors, national management companies, and other industry consolidators. Physicians can deliver the highest-quality care while also benefiting financially from the success of their ASC.
Specialization and Focus: The ophthalmic specialization fosters a culture of excellence and innovation, driving continuous improvement in patient care and outcomes with specialized procedures, equipment, staff, and operations.
Innovation is at the core of the OOSS mission to help our members provide safe patient care and best outcomes. OOSS works with physicians and industry to ensure innovation is encouraged, supported, and regulated. Innovation is in our DNA. Our professional society was formed by innovators looking for solutions to be safe, effective and efficient. Our members tend to be early adapters of innovative products and devices and our board members include key opinion leaders eager to advance innovation in patient care. We regularly feature innovations in our educational events. Recently, we hosted panels of physicians, administrators, and industry executives discussing innovation in glaucoma as well as the light-adjustable lens (LAL), with experts sharing their experience, perspectives, and advice. (Videos of the panels can be viewed at ooss.org). In October, innovation in retina will be a provocative topic at the OOSS Symposium, held during the American Academy of Ophthalmology’s annual meeting in Chicago.
As opportunities are presented to our members, we continue to examine and evaluate. While office-based surgery (OBS) has been a hot topic, heavily promoted as innovative by a commercial company, OOSS and other professional organizations have consistently communicated concerns about patient safety and the lack of regulation and oversight with this model.
For the past decade, advocates for OBS have been seeking facility reimbursement from Medicare. In 2015, CMS published a request for information on the advisability of establishing a fee for cataract surgery furnished in the office. After strenuous lobbying from OOSS, CMS declined to move forward with this fee. In 2022, an OBS promoter suggested expanding the array of procedures to include MIGS and vitrectomy codes. Again, when CMS solicited comments, OOSS mounted an aggressive campaign opposing this measure, citing the significant patient health and safety risks associated with such services and emphasizing the need for offices to meet standards comparable to those applied to ASCs. Again, CMS declined to change its policy, which currently permits the surgeon performing OBS to bill only for their professional fee and the standard IOL.
The ambulatory surgery center remains the safest and most efficient, productive, and financially sound environment for ophthalmic patients, surgeons, and staff. We should covet the current model, while supporting innovation that keeps our facilities fresh and nimble. OASC
