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50 OUTPATIENT SURGERY Ambulatory Surgery Center Association 'sharply rebukes' Kaiser Health News, USA Today for report on surgery centers: 6 things to know By Megan Wood T he Ambulatory Surgery Center As- sociation responded to a report pub- lished by Kaiser Health News and USA Today titled, "As Surgery Centers Boom, Patients Are Paying With eir Lives." Here are six things to know. 1. ASCA's leadership published a press release, stating the society "sharply re- buked" KHN and USA Today for their re- port on surgery centers. e report featured results from an investigation conducted by the two publications. Reporters investigated autopsy records, legal filings and more than 12,000 state and Medicare inspection records. Additionally, the reporters interviewed doz- ens of physicians, patients and health policy experts for the story. 2. e investigation revealed more than 260 patients have died aer outpatient procedures at surgery centers since 2013. ASCA count- er-argued that the article did not mention ASCs' 200 million-plus safely performed pro- cedures in that five-year timeframe. "By not putting the number of adverse events into context, this article misleads readers into thinking that ASCs have more adverse events than other sites of service, when they actually have fewer," the ASCA press release states. 3. e report states most surgery center pro- cedures don't result in any complications, es- pecially if the ASC possesses the appropriate equipment and highly trained staff to deal with emergencies. e investigators found more than 12 instances, however, where ASCs were not compliant. 4. ASCA CEO William Prentice said in the press release: "KHN and USA Today have done a terrible disservice to their readers in their article about ambulatory surgery cen- ters by failing to accurately and responsibly report the high-quality, high-value outcomes occurring in ambulatory surgery centers to- day. By focusing their story on a relatively small number of tragic errors, while ignoring the overwhelming beneficial outcomes found in ASCs, they have created a false and mis- leading narrative about the safety and efficacy of outpatient surgery." 5. e ASCA response concluded with a comment from Rebecca Craig, RN, CEO of Harmony Surgery Center and Peak Surgical Management in Fort Collins, Colo., who ac- knowledged the report features tragic patient stories that will "no doubt be deeply concern- ing to readers." However, she criticizes the article for lacking transparency on medical error occurrences across all sites of care, in- cluding hospitals. "And, while serious adverse events are rare in every setting, they are even rarer in ASCs be- cause the model of care is based on using each patient's health history to assure the highest probability of successful outcomes." 6. Currently, 5,616 Medicare-certified sur- gery centers exist. n ACDF outpatient surgery costs significantly lower than inpatient: 3 key points By Mackenzie Garrity A study published in Neurosurgery found anterior cer- vical discectomy and fusion costs were significantly lower when performed in outpatient settings. Researchers studied 3,135 outpatient surgeries and 46,996 inpatient surgeries throughout California, Florida and New York from 2009 to 2011. Here are three key points. 1. Average costs for ACDF procedures in outpatient set- tings was $33,362 while in inpatient settings patients' bills reached $74,667. 2. In the outpatient group, 168 (5.4 percent) went to the emergency department within 30 days compared to 2,607 (5.5 percent) of patients who underwent inpatient surgery. 3. Fifty-one (1.6 percent) of outpatient patients were read- mitted and five (0.2 percent) underwent reoperation. In the inpatient group, 1,778 patients (3.8 percent) were readmit- ted and 200 (0.4 percent) underwent reoperation. Study authors concluded, "ACDF can be performed in an ambulatory setting with comparable morbidity and read- mission rates, and lower costs, to those performed in an inpatient setting." n "By not putting the number of adverse events into context, this article misleads readers." - Ambulatory Surgery Center Association