To achieve enrollment with the Centers for Medicare and Medicaid Services (CMS) and qualify for Medicare reimbursement and Medicaid reimbursement, ambulatory surgical centers (ASCs) have the option to choose between two primary routes: accreditation with an organization like QUAD A or state certification through a state survey.
Two Paths to CMS Reimbursement for Ambulatory Surgical Centers
While both achieve the same outcome, the two routes have some key differences.
- State survey certification: Conducted by a state agency, this survey assesses compliance with state regulations and the Medicare Conditions for Coverage (CfCs). The CfCs establish the minimum health and safety standards required to participate in Medicare and Medicaid.1
- QUAD A accreditation: QUAD A is a CMS-approved Accrediting Organization. Achieving QUAD A accreditation signifies that an ASC has met CMS regulatory requirements and has voluntarily committed to a more comprehensive set of standards. It also demonstrates a facility's commitment to excellence in providing patient-centered care, safety, and quality.
Debunking Misconceptions: QUAD A Accreditation vs. State Surveys - Key Differences
While there are similarities between an accreditation survey vs. a state agency survey, understanding the difference is key to choosing the right path for your facility. For example:
- Myth: A QUAD A accreditation survey is more challenging and demanding than a state survey.
- Fact: QUAD A strives to be an effective, efficient, and easy-to-work-with partner that values education, reliability, and communication. In addition, our thorough processes, expert surveyors, and collaborative approach go beyond what state or federal agencies provide.
- Myth: The two types of accreditation are generally the same.
- Fact: The government mandates state surveys to ensure facilities meet minimum regulatory requirements. QUAD A accreditation, on the other hand, is a voluntary and comprehensive process that goes above and beyond typical requirements. ASCs that achieve QUAD A accreditation set themselves apart from the competition by demonstrating their commitment to the highest, most rigorous safety and quality standards. Furthermore, ASCs that receive QUAD A accreditation play an important role in educating patients and their communities on the importance of accreditation, and QUAD A provides marketing resources to help ASCs in this valuable endeavor.
- Myth: QUAD A accreditation may be redundant with state surveys.
- Fact: Some sources suggest that physicians view state surveys and QUAD A accreditation as overlapping or redundant.2 However, it’s important to note that QUAD A’s accreditation represents a higher standard of quality beyond basic licensure. If a facility has achieved QUAD A accreditation, it means the facility has not only met but exceeded industry benchmarks in patient care, safety, and efficiency. For example, QUAD A promotes a culture of continuous quality improvement by requiring facilities to maintain 100% compliance always, rather than just preparing for a regulatory state inspection survey. QUAD A also works with more specialized standards for specific types of facilities – in other words, the standards for ASCs are tailored to their unique needs and risks, making them highly relevant and impactful for your daily operations.
4 Key Steps in the QUAD A Accreditation Process
For ASCs, the path to QUAD A accreditation is straightforward and is designed to be as efficient as possible:
- Step 1: Application: The ASC completes the QUAD A application.
- Step 2: Survey: QUAD A secures a qualified surveyor to evaluate the facility (typically within 30-45 days).
- Step 3: Committee Review: QUAD A’s Accreditation Committee will grant your facility accreditation once all post-survey activities have been satisfied.
- Step 4: Notification: QUAD A is a recognized “deeming authority” by CMS, which means our accreditation program meets or exceeds Medicare requirements. QUAD A notifies CMS, on your behalf, facilitating enrollment. CMS is the final authority to grant Medicare enrollment into the Medicare certification program.
Partner with QUAD A for a Path to Excellence
QUAD A acts as your intermediary with CMS, helping you meet regulatory requirements and navigate changes with confidence. When you partner with us, you get a trusted, unbiased ally who shields you from bureaucratic roadblocks and provides clear guidance every step of the way.
A Higher ASC Accreditation Standard
QUAD A’s requirements capture what matters, so you see a return for every bit of time you put into accreditation. Becoming accredited also places you among peers who play at your level. A board and committee of healthcare professionals (including MDs and RNs) develop, evaluate, and maintain our standards. What’s more, since our surveyors have worked in your healthcare setting, they can explain standards in a way that’s highly relatable and clear.
Ongoing ASC Quality and Safety Improvement
Choosing QUAD A means more than just meeting CMS requirements. You gain a trusted partner dedicated to your success. We act as your intermediary with CMS, helping you navigate regulatory complexities with confidence. Our support continues long after the survey with resources to help you market your achievement and identify ongoing opportunities for improvement.
QUAD A accreditation is an ongoing partnership, not a one-time inspection. We provide annual touchpoints and continuous support to help you validate your successes and pinpoint opportunities for growth in operations, safety, and patient care. Unlike a survey that ends when the surveyor leaves, we remain a dedicated resource. Our focus is solely on accreditation, which means we are constantly evolving our standards and support based on real-world data to ensure we are providing you with the most current best practices.
To elevate your facility and get started with QUAD A accreditation, contact us here. We look forward to clearing a path with you toward successful accreditation and CMS enrollment.
Sources:
- Centers for Medicare & Medicaid Services. (2023, September 6). Conditions for coverage (cfcs) & conditions of participation (CoPs) | CMS. Www.cms.gov. https://www.cms.gov/medicare/health-safety-standards/conditions-coverage-participation
- AHA Comments on CMS Proposal on Accrediting Organization Oversight | AHA. (2024, April 12). American Hospital Association. https://www.aha.org/lettercomment/2024-04-12-aha-comments-cms-proposal-accrediting-organization-oversight
Since 1980, QUAD A (a non-profit, physician founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of health care they provide – believing that patient safety should always come first. To learn more about QUAD A, their accreditation process, and why it’s so important to seek out accredited facilities when making healthcare related decisions, visit www.quada.org.