ABASC 2024 - California

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METHODOLOGY

The fourth edition of America's Best Ambulatory Surgery Centers awards the leading 550 ambulatory surgery centers (ASC) in the U.S. based on quality of care, performance data and peer recommendations, relative to in-state competition.

Included ASCs operate 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.

The 25 states with the most facilities according to the U.S. Centers for Medicare and Medicaid Services (CMS) were surveyed individually. The remaining states were grouped into four regions: Northeast, Midwest, West, South. ASCs from these states were considered accordingly.

Over 5,000 ASCs were analyzed resulting in a varying number of ASCs awarded per state: California had 86 ASCs awarded, while Mississippi is represented with five ASCs.

To create the ranking, a score was calculated for each ASC that was part of the analysis. The total score is based on a national online survey and quality metrics data.

National Online Survey - Reputation Score

The Reputation Score (67 percent of total score) is based on three sub-scores:
• Recommendation Score
• Quality Score
• COVID-19 Score

1. Recommendation Score:

From June to July 2023, Statista conducted a nationwide online survey among medical professionals (medical doctors/surgeons, registered nurses, nursing assistants, therapists) and staff working in the management/administration in ambulatory surgery centers. The survey was available to medical experts to participate on Newsweek.com. Additionally, participants were invited via e-mail.

Participants were asked to recommend notable ASCs in their respective state. Recommendations for own employer/ambulatory surgery center were not allowed.

Recommendations received different weights depending on the order in which they were given, with the first recommendation being assigned the highest weight. Additionally, the professional experience of the participant was considered.

The recommendation score constitutes 70 percent of the reputation score.

2. Quality and COVID-19 Score:

For each recommended ASC participants were asked to rate four quality dimensions on a scale from 1 ("Poor") to 10 ("Excellent").
• Management of the COVID-19 crisis (e.g., safety & hygiene measures)
• Management of waiting time (e.g., appointments)
• Quality of surgical care (e.g., procedure)
• Quality of follow-up care (e.g., physical therapies)

The quality score constitutes 20 percent and the COVID-19 score constitutes 10 percent of the reputation score.

Quality Metrics Score

The Quality Metrics Score (33 percent of total score) is based on publicly available data:

The U.S. Centers for Medicare & Medicaid Services provides quality metrics data on ASCs in the Ambulatory Surgical Center Quality Reporting (ASCQR) Program.

The quality metrics data includes the following eight measures:
• Measure 1: Endoscopy/Polyp Surveillance: Appropriate Follow-up Interval for Normal Colonoscopy in Average Risk Patients
• Measure 2: Cataracts: Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery
• Measure 3: Facility 7-Day-Risk-Standardized Hospital Visit Rate after Outpatient Colonoscopy
• Measure 4: Normothermia Outcome
• Measure 5: Unplanned Anterior Vitrectomy
• Measure 6: Hospital Visits after Orthopedic ASC Procedures
• Measure 7: Hospital Visits after Urology ASC Procedures
• Measure 8: COVID-19 Vaccination Coverage Among Health Care Personnel

For a center to receive a Quality Metrics Score, it must have reported a minimum of 2 measures within the reporting period. Centers that reported fewer measures did not receive a Quality Metrics Score and were rated based on the Reputation Score only.

Disclaimer

The rankings are comprised exclusively of ambulatory surgery centers that are eligible regarding the scope described in this document. The ranking is the result of an elaborate process which, due to the interval of data-collection and analysis, reflects the last 12 months only. Furthermore, events preceding or following the period September 1, 2022 – September 1, 2023, and/or pertaining to individual persons affiliated/associated to the facilities were not included in the metrics. As such, the results of this ranking should not be used as the sole source of information for future deliberations.
The information provided in this ranking should be considered in conjunction with other available information about ambulatory surgery centers or, if possible, accompanied by a visit to a facility. The quality of ambulatory surgery centers that are not included in the rankings is not disputed.

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Download the full methodology here.