It is important to remember that hospital transfers are not a proxy for low-quality medical care and can, in fact, be an indicator of high-quality care. ASCs frequently transfer patients to the hospital before their procedures begin because some unrelated condition is detected when a patient arrives at the ASC and a hospital visit is deemed necessary. Transfers like those are a positive reflection on the care ASCs provide.
Because ASCs cannot provide overnight care and monitoring, it is often the physician operating out of an abundance of caution who transfers higher numbers of his or her patients to the hospital for overnight care.
It is true that different quality reporting programs have different requirements, so, if Joan Rivers wasn’t a Medicare patient, for example, her hospital transfer would not have been reported to Medicare since that program collects data only on its beneficiaries. Likewise, a state quality reporting program might not ask for information on some measure like patient falls although that information would be reported to the Medicare quality reporting program when a Medicare beneficiary is involved.
As I said earlier, the quality reports that would be most useful to patients considering outpatient surgery would allow them to make direct comparisons over all the sites of care—ASCs, HOPDs and physicians’ offices. Ideally, these patients would also be able to compare the costs of their care in each of those settings as well.