ASCA News Digest (April 8, 2014)

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April 8, 2014





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ASCA Highlights


Still Time to Sign Up for 2014 ASCA Benchmarking Program

The data collection period for the first quarter of 2014 (Q1) will close in three weeks on April 30. Start submitting your data now. If you haven’t purchased your 2014 subscription yet, you still have time to sign up. Unlike last year, we will not be offering pro-rated pricing for subscribing after the first quarter’s data collection closes. Sign up today. MORE
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CMS announced that it will delay the implementation of the new quality reporting measure ASC-11, Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery, until January 1, 2015. CMS intends to propose guidelines regarding data collection for this measure in its upcoming 2015 proposed ASC payment rule. MORE
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President Obama signed a one-year patch for the SGR to postpone a 24 percent cut in Medicare payments to physicians that had been scheduled to take effect last week. Contained within the patch is a provision delaying the implementation of ICD-10 for one year. Most concerning for specialty physicians and surgeons is a provision used to pay for the $20 billion patch that implements severe payment cuts for services that are deemed to be ‘misvalued’ within the Medicare physician payment system. MORE
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ASCA and US Representative Charlie Dent (R-PA) released a new public service announcement encouraging viewers to schedule their own colonoscopies, in consultation with their physicians, and talk to their friends and family about the importance of early detection. “We lost my brother-in-law to this terrible disease and I saw how painful and difficult it was on my family,” Rep. Dent says in the video. MORE
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Want to attend the June Capitol Fly-In but unsure how to advocate for ASCs on a national stage? ASCA is offering an Advocacy in Action Training program Tuesday evening to help you prepare for the next day’s congressional meetings. Learn what to say in congressional offices, how to say it and how to be an effective advocate during a one-hour presentation and mock congressional meeting exercise. MORE
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The medical and surgical supplies used in ASCs represent the second largest expense, after staffing, for most facilities. Keeping control of what is purchased and how the items move off the shelf is essential to a reduction in supply expenses each week. In addition, procurement practices in an ASC that promote disclosure and education of care providers, at all levels, fosters the development of a more knowledgeable surgery center team. MORE
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Last week, ASCA staff met with AARP staff to discuss the role ASCs play in the health care delivery system. During the meeting, both parties discussed the University of California-Berkeley study that indicates ASCs save Medicare $2.3 billion a year while saving beneficiaries hundreds of millions at the same time. MORE
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Industry News


ICD-10 Delay Puts Pressure on CMS for Answers
Modern Healthcare (04/01/14) Carlson, Joe; Robeznieks, Andis

President Barack Obama signed into law on April 1 a bill that postpones nationwide deployment of the ICD-10 medical coding system until at least Oct. 1, 2015. However, it is uncertain if that date will become the new deadline and whether Centers for Medicare & Medicaid Services will let organizations that are ready to voluntarily implement ICD-10. The move may be beneficial for smaller health care providers that were not prepared for the conversion, says Workgroup for Electronic Data Interchange's Devin Jopp. However, some hospitals and insurers are wondering whether they should continue their "dual-coding" efforts. Dr. John Halamka at Beth Israel Deaconess Medical Center in Boston suggests that hospitals might use ICD-10 internally and convert those codes to ICD-9 for billing. He adds that the National Library of Medicine has software available for download that can perform the ICD-10-to-ICD-9 conversion.
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Doctors' Medicare Payment Data Finally Set for Release
Modern Healthcare (04/02/14) Carlson, Joe

The Centers for Medicare and Medicaid Services (CMS) could begin releasing Medicare billing and payment data belonging to 880,000 doctors and other healthcare providers as early as April 9, despite opposition from the American Medical Association (AMA) and individual physicians. The data that will be released will be taken from $77 billion worth of Medicare Part B payments from 2012, and it will include information about how healthcare providers billed Medicare for services as well as what they were paid. Doctors' provider IDs and their patient volumes will also be released. CMS Principal Deputy Administrator Jonathan Blum said making the data available to the public will make Medicare payments to doctors more transparent and will help identify fraud, waste, and abuse in Medicare. But the AMA said it is concerned that members of the public who view the data will use the information to make potentially harmful decisions about treatments while at the same time encouraging an "unwarranted bias" against physicians that could make it difficult or even impossible for them to practice medicine.
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Anesthetic Technique Important to Prevent Damage to Brain
Medical Horizons (03/31/2014)

A widely used anesthetic technique to lower blood pressure could raise the likelihood of depriving the brain of oxygen, say researchers from the University of Adelaide. Hypotensive anesthesia can slow the arterial blood pressure by up to 40 percent. "However, if the blood pressure is lowered too far this may cause damage to the brain and other organs," says P.J. Wormald at the Queen Elizabeth Hospital in Adelaide, Australia. He says his studies indicate that "the brain can only autoregulate up to a point, and cannot completely adapt to such low blood pressures." In a paper, Wormald has made recommendations for a safer approach to hypotensive anesthesia. The report , which was published in the journal The Laryngoscope, focuses on 32 patients who underwent endoscopic sinus surgery.
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American College of Surgeons and Safe Surgery 2015 Leaders Discuss Outcomes, Vision for South Carolina Surgical Safety Checklist Initiative
American College of Surgeons (04/03/2014)

The American College of Surgeons recently hosted the ACS Surgical Health Care Quality Forum South Carolina to highlight the importance of customizing the World Health Organization's Surgical Safety Checklist to fit each hospital's culture and workflow. Officials at Safe Surgery 2015 estimate that if the checklist were used for every patient undergoing surgery in the state of South Carolina, it could save at least 500 lives annually and prevent 2,000 complications while saving an estimated $28 million in health care costs. The program also highlighted how surgeons drive meaningful implementation of the checklist by encouraging communication and building engagement in the operating room.
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Burnt Out Primary Care Docs Are Voting With Their Feet
Kaiser Daily Report (04/01/14) Rabin, Roni Caryn

Studies and anecdotal reports point to a significant increase in the level of stress among physicians, in particular primary care doctors. Some doctors try to reduce stress by working for large groups or hospitals where hours are more regular or by migrating to concierge-style practices. A 2012 study by the Urban Institute of 500 primary-care doctors found that 30 percent of those between the ages of 35 to 49 intended to leave their practices within five years, rising to 52 percent for those over 50. Efforts to increase compensation for primary care doctors have been lackluster because while specialists' pay is based chiefly on procedures, primary care doctors are typically paid per visit and are not reimbursed for managing their patients' care outside of visits.
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New Guidance System Could Improve Minimally Invasive Surgery
Johns Hopkins Medicine (03/27/14)

A computerized process developed at Johns Hopkins University could make minimally invasive surgery more accurate and streamlined. Initial tests of the algorithm reveal that the image-based guidance system may perform better than traditional systems used for surgical navigation. Jeffrey Siewerdsen at the Johns Hopkins University School of Medicine in Baltimore says the team's approach involves the use of a mobile C-arm, a piece of equipment already used in many surgeries. He says, "In this work, we devised an imaging method that could overcome traditional barriers in precision and workflow. Rather than adding complicated tracking systems and special markers to the already busy surgical scene, we realized a method in which the imaging system is the tracker and the patient is the marker."
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Highmark to Fund New Surgery Center
Pittsburgh Business Times (04/04/14) Mamula, Kris B.

Highmark Inc. is planning to spend $25 million to build an ambulatory surgery center in Bethel Park, Pa., as part of Highmark's investment in Jefferson Hospital. The plans include the expansion of medical and surgical cancer care services and a new maternity unit to open in the fall. Jefferson Hospital is part of Highmark's Allegheny Health Network of hospitals. Highmark plans to spend $118 million in community health reinvestment projects in the coming year.
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Intuitive Surgical Gets FDA Clearance for Robotic Surgical System
Wall Street Journal (04/01/14) Walker, Joseph

The U.S. Food and Drug Administration has granted Intuitive Surgical Inc. clearance for a new model of its da Vinci surgical robot. The new version, the da Vinci Xi System, features overhead surgical arms that enable users to reach patients' anatomy without repositioning the machine during surgery. Compared to the current model, the new robot's arms are thinner and have a greater range of motion, said Salvatore J. Brogna, senior vice president for product development at Intuitive Surgical, and this should allow for smoother operation and help avoid the surgical arms interfering with one another.
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Call to Action on Patient and Family Engagement in Health Care From the NPSF Lucian Leape Institute
National Patient Safety Foundation (03/19/2014)

"Safety Is Personal: Partnering with Patients and Families for the Safest Care," a new report by National Patient Safety Foundation's Lucian Leape Institute, recommends targeted training for health care providers to ensure they are knowledgeable about engaging patients in decisions and management of health problems. "Many of the barriers to meaningful patient and family engagement can only be overcome if leaders and clinicians support them in becoming confident and effective partners," says Susan Edgman-Levitan, a member of the institute and lead author of the report. "With this report, we hope to influence health leaders and practitioners to act on the evidence and knowledge we already have."
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Some Democrats Fight Obama Over Medicare
Wall Street Journal (04/07/14) P. A4 Peterson, Kristina; Mathews, Anna Wilde

Several Democratic lawmakers are opposed to proposed cuts to private plans offered under Medicare Advantage, which are likely to be included in projected 2015 payments to be unveiled on April 7. However, other Democrats view some of the cuts as necessary changes to achieve the Affordable Care Act's approximately $700 billion in Medicare savings over 10 years. About half of the cuts included in the proposed payment rates released in February were linked to factors other than the health law, notes Chris Rigg at Susquehanna Financial Group. An industry report says one way for the administration to reduce the cuts would be to extend a special initiative to provide extra payouts to health plans based on their scores on certain quality measures.
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State Officials Cite Technology Problems on Health Insurance Sites
New York Times (04/04/14) P. A14 Pear, Robert

At a congressional hearing on April 3, officials from Hawaii, Maryland, Massachusetts, Minnesota, and Oregon discussed the technical problems that have plagued the health insurance exchanges they built with federal dollars. Scott Leitz, interim CEO of the Minnesota exchange, talked about software errors and technical glitches that hindered the exchange's roll out, while Tom Matsuda, interim executive director of Hawaii's exchange, said the exchange received $205 million in federal grants but enrolled just 7,600 people, averaging $27,000 per enrollee. U.S. Rep. James Lankford (R-Okla.) questioned how these states could have such problems after receiving about $1 billion in federal grants and wondered how many more taxpayer dollars would be required to bail out these exchanges.
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