ASC Value-Based Contracting & Quality Reporting Strategy

ASC Value-Based Contracting & Quality Reporting Strategy

The CMS ASC Quality Reporting Program (ASCQR) requires that Medicare-certified ASCs report data on a defined set of quality measures as a condition of receiving the full annual Medicare payment update. Failure to meet ASCQR reporting requirements results in a 2% reduction in Medicare payment rates — a financial penalty that, for most ASCs, represents a meaningful dollar amount. More importantly, ASCQR data is publicly reported on the CMS Care Compare website — making your ASC's quality performance visible to patients, referring physicians, and payers.

Beyond CMS, commercial payers are developing increasingly sophisticated ASC quality programs — using quality measure performance data to make network inclusion decisions, direct patient volume, and determine quality bonus payments in value-based contract arrangements. The ASCs that build the data infrastructure, quality improvement capability, and quality reporting systems to perform well on these measures now will be positioned for competitive advantage as value-based contracting expands.

CMS ASC Quality Reporting Program (ASCQR)

• Required Measure Reporting — Support for compliance with ASC Quality Reporting (ASCQR) requirements, including patient experience measures (ASC CAHPS), clinical outcomes, and appropriate use of imaging, with development of data collection, validation, and timely submission processes

• ASC CAHPS Survey Program — Implementation and management of the ASC CAHPS patient experience survey, including sampling methodology, survey administration, data submission to the ASCQR contractor, and analysis of results to inform quality improvement initiatives

• Public Reporting Management — Oversight and optimization of ASC publicly reported quality data on Care Compare, including performance interpretation, identification of reporting gaps, and targeted improvement strategies to enhance publicly visible quality metrics

Commercial Value-Based Contracting

• Commercial Value-Based Contract Evaluation & Negotiation — Assessment and negotiation of ASC value-based arrangements with commercial payers, including performance metrics, measurement methodologies, data-sharing requirements, attribution models, and financial risk/reward structures

• Value-Based Revenue Optimization — Strategic positioning for ASCs with strong quality performance to capture incremental revenue opportunities beyond fee-for-service reimbursement through payer-aligned value-based contracting arrangements