ASCA News Digest (April 29, 2014)

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April 29, 2014





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ASCA Highlights


Online Registration for ASCA 2014 Closes Tomorrow

Online registration for ASCA 2014, as well as registration via fax, email and phone, will close tomorrow. ASCA members can save more than $100 off of the full registration price and enjoy additional savings by sending more than one attendee (all registrations must be received at the same time, received from the same address and covered under one payment). Register today. MORE
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The data collection period for the first quarter of 2014 (Q1) closes tomorrow. Start submitting your data now. If you haven't purchased your 2014 subscription yet, get the best value you can—subscribe today to take advantage of submitting your benchmarking data for all four quarters. Unlike last year, we will not be offering pro-rated pricing for subscribing after the first quarter’s data collection closes. MORE
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Already registered for the annual meeting? The ASCA 2014 Community on ASCA Connect is a great place to network with other attendees and submit questions to the speakers. Let people know you are attending and help promote the conference using the hashtag #ASCACONF on social media sites such as Twitter, Facebook and LinkedIn. MORE
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In response to member feedback, the ASCA Medicare Rate Calculator was revised to include one worksheet with all of the information based on CMS published rates and a separate worksheet to show the effect sequestration has on these rates. With the new rate calculator, you just input your state and county—you don’t need to go to a separate worksheet anymore to find your wage index. MORE
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The concept of "Total Communication" is often used to refer to an effective patient communication system that has three primary components and can lead to an authentic connection with patients. Individuals are often likely to have strengths in one or two of the areas and opportunities for improvement in the others. Core competence in all three, and careful attention to each, makes for compassionate, patient-centered staff. MORE
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Hospira, Inc. announced a voluntary nationwide recall to the user level for one lot of 0.25% Marcaine (Bupivacaine HCl Injection, USP), 10 mL, Single-dose Vial – Preservative Free (NDC 0409-1559-10), Lot 34-440-DD. The recall is due to a confirmed customer report of discolored solution with visible particles embedded in the glass as well as discolored solution. MORE
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Learn how legislative and regulatory changes pending in Washington, DC, could affect your ASC and what you can do to promote and protect your ASC’s interests at ASCA 2014, May 14–17 in Nashville. The Give-A-Latte campaign will be back: unlimited free specialty beverages will be available for ASCAPAC members Thursday and Friday in the Exhibit Hall. MORE
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Industry News


With Medical Debts Rising, Doctors Are More Aggressive About Payments
Kaiser Health News (04/25/14) Gold, Jenny

As more patients seek to postpone paying their bills, spurred in part by the economic downturn and growing use of high-deductible insurance plans, medical practices are having to be more aggressive about collecting payments. A survey by the Medical Group Management Association found that between 2008 and 2012, multispecialty practices saw their bad debt--money they were owed but could not collect--increase 14 percent. In response, some practices have had to change their billing strategies, including sending patients who do not pay to collection agencies faster. Another option--one used at Mid State Orthopaedic and Sports Medicine Center in Alexandria, La., where 11 doctors see about 300 patients daily--is to collect the payment before the procedure is performed. Patients there go to one billing desk for copayments and then a second station, where two employees whose sole job is to collect payments will help them go through their options, accessing a patient's insurance details to determine the exact sum owed and setting up payment plans if necessary.
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AAAASF Welcomes New CEO, New COO
AAAASF Week in Review (04/24/2014)

James Pavletich has been appointed as the new chief executive officer of the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). He joins from the Accreditation Association for Ambulatory Health Care, where he most recently served as Vice President/COO and General Manager, Ambulatory Operations. Theresa Griffin-Rossi has been appointed as AAAASF's new chief operating officer, and has served AAAASF for the past 13 years in management positions, most recently as Interim Executive Director. Both appointments take effect on May 1.
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ICD-10 Delay Will Cost Practices More Money, Survey Says
Medical Economics (04/23/14) Marbury, Donna

A white paper by Part B News reveals that many medical practices were well on their way to migrating to the new ICD-10 coding system and training their staff prior to its postponement. More than 60 percent of respondents said their practices had identified resources, created a project plan, and contacted vendors based on the timeline of the Centers for Medicare and Medicaid Services for preparing for ICD-10. In addition, more than 50 percent were involved in training staff on coding and documentation. Thirty-one percent of survey respondents said they were unhappy with the ICD-10 delay because they had been prepared for the new system, while nearly 34 percent said they would have been ready for the October 2014 target date but appreciate the extra time.
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How Medicare Data Could Revolutionize Health Care
Fiscal Times (04/23/14) Wasik, John F.

In response to a court ruling, the federal government on April 8 publicized approximately $77 billion in payments by the Centers for Medicare and Medicaid Services to nearly 1 million providers during 2012, and similar data will be released on hospitals and clinics in about a month. If these figures are properly analyzed, they could potentially yield patterns that can help answer such concerns as whether Medicare-paid physicians over-treat their patients, or whether the highest-paid doctors are requesting a disproportionate number of procedures and tests or writing excessive prescriptions. It may be beneficial to compare the results with those of a country with a national health care program in which procedures are evaluated for cost and effectiveness. A "control" group would be required to make benchmark comparisons.
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Health Law's Pay Policy Is Skewed, Panel Finds
New York Times (04/28/14) P. A13 Pear, Robert

According to a study commissioned by the Obama Administration and conducted by a National Qualify Forum panel, doctors and hospitals treating large numbers of poor people are unfairly penalized by federal policies rewarding high-quality health care. In a draft report, the panel says the measures of quality used by Medicare and private insurers in paying providers are fundamentally flawed because they fail to recognize that it is harder to achieve success when treating patients with low incomes and little education. The 26-member panel recommends that measures of quality and performance be adjusted for various sociodemographic factors to avoid hurting safety-net providers, but the Obama Administration is concerned that such adjustments would be equivalent to accepting a double standard, with lower expectations for care provided to low-income patients.
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15-Minute Visits Take a Toll on the Doctor-Patient Relationship
Kaiser Health News (04/21/14) Rabin, Roni Caryn

Physicians often rush through appointments to see more patients as a way to make up for declining reimbursements, but this can be detrimental to the doctor-patient relationship. Although many primary-care doctors' appointments are scheduled every 15 minutes, some physicians working for hospitals say that they have been asked to see patients every 11 minutes. This problem may get worse as millions of consumers seek care after getting health coverage through the Affordable Care Act. The doctor-patient relationship is considered a key to good care, and a lack of dialogue between patient and doctor could be a missed opportunity for getting patients more actively involved in their own health care.
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The Frequency of Diagnostic Errors in Outpatient Care: Estimations From Three Large Observational Studies Involving US Adult Populations
BMJ Quality and Safety (04/17/2014) Singh, Hardeep; Meyer, Ashley N.D.; Thomas, Eric J.

Approximately 12 million adults are misdiagnosed in outpatient settings each year, according to new research. The study estimated the frequency of diagnostic errors among adults in the United States, using data from three earlier studies of clinic-based populations that used similar definitions of diagnostic error. Two of the studies used algorithms to identify unusual patterns of return visits following an initial primary care visit or a failure to follow up after abnormal clinical findings related to colorectal cancer, while the third study looked at consecutive cases of lung cancer. The researchers estimate that about one in 20 U.S. adults is affected by diagnostic errors. They suggest that their findings "should encourage policymakers, health care organizations, and researchers to start measuring and reducing diagnostic errors."
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Doctors, Medical Staff on Drugs Put Patients at Risk
USA Today (04/17/14) Eisler, Peter

A USA Today review of government data and independent studies reveals that more than 100,000 doctors, nurses, technicians, and other health professionals are addicted to narcotics and other prescription drugs, and because their knowledge and access make it difficult to detect their problems, patients are at risk. Since 2009, there have been three hepatitis outbreaks involving health care workers using syringes meant for patients. No state requires universal drug testing, and many do not have rules requiring medical facilities to inform law enforcement or regulators when employees are caught abusing or diverting drugs. Most states have special rehabilitation programs for health care practitioners, and while experts say those who need treatment will not voluntarily enroll if they face discipline, some insist that a law enforcement component is necessary in order to protect patients.
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Relative Influence on Total Cancelled Operating Room Time From Patients Who Are Inpatients or Outpatients Preoperatively
Anesthesia & Analgesia (04/14) Dexter, Franklin; Maxbauer, Tina; Stout, Carole; et al.

Conducting a virtual evaluation by phone can help to reduce the number of operating room (OR) cancellations for outpatient procedures. New research shows that approximately 50 percent of the cancelled OR times at health systems and hospitals is related to inpatients, even though they represented less than half the total scheduled minutes of surgery. For outpatients, the researchers note that physical visits to a preoperative clinic had little or no effect on cancelled OR time, compared to preop telephone calls instead. The virtual evaluations by phone can help facilities to achieve a cancellation rate of 2 percent or less for outpatient surgery. "Hospitals should evaluate the cost-effectiveness of earlier assessments of inpatients," the researchers conclude. "In addition, scheduling office decision-making within 1 workday before surgery should be based on statistical forecasts that include the risks of cancellation and of inpatient add-on cases being scheduled."
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