Clinical Scorecard: Ambulatory Surgery Center Governance and Growth

At a Glance

Key Highlights

• ASC ownership is the single most important growth factor for ophthalmology practices, offering superior reimbursement rates compared to hospitals.
• Patient preference favors ASCs located within or near the physician’s practice due to familiarity and convenience, enhancing patient experience.
• Compliance with federal regulations, including fraud and abuse laws and Stark Law, is critical when structuring ASC ownership and referral arrangements.

Guideline-Based Recommendations

Diagnosis

Management

• Consider ASC ownership or partnership as a strategic growth tool to capture facility fees and increase revenue.
• Evaluate whether to build a new ASC or buy into an existing compliant ASC, considering operational fit and equipment preferences.
• Structure ownership and referral arrangements to comply with federal fraud and abuse laws and Stark Law safe harbors.

Monitoring & Follow-up

• Conduct thorough due diligence on compliance status when acquiring or investing in an existing ASC.
• Monitor ongoing compliance with federal regulations to avoid investigations and penalties.

Risks

• Non-compliance with federal fraud and abuse laws can lead to legal investigations and financial penalties.
• Investing in non-compliant ASCs or improper ownership structures may jeopardize practice revenue and reputation.

Patient & Prescribing Data

Patients undergoing ophthalmic surgical procedures, such as cataract surgery

Performing procedures in ASCs can improve patient experience and convenience while optimizing reimbursement rates.

Clinical Best Practices

• Align ASC operations with physician practice workflows to maximize efficiency and physician productivity.
• Select surgical equipment in ASCs that matches physician training and preferences to maintain quality of care.
• Use ASC ownership to engage and incentivize physician partnerships and succession planning within the practice.

Related Resources & Content

• ASCRS 2026 Annual Meeting Presentation on Ambulatory Surgery Centers
• Ophthalmology Management Interview with Isabelle Bibet-Kalinyak, JD, MBA and Rajesh U. Kothari, MBA