ASCA News Digest (August 26, 2014)

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August 26, 2014





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ASCA Highlights


Your Input Needed on CMS Reimbursement Proposal for 2015

Your input is needed in response to CMS' proposed ASC reimbursement rates for 2015. ASCA will once again submit comments raising industry-wide concerns, but it is important that CMS hear from individual centers. ASCA has created draft comment letters and sample language to make it easy for you to customize and submit a comment letter to CMS. MORE
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This is the last week to take advantage of early registration discounts for ASCA’s 2014 Fall Seminar. The early registration deadline is this Sunday, August 31. This one-of-a-kind program will examine the most important topics in ASC management today and dig deep into the realities of building for the future while providing the best value, service and patient care possible today. Find out why this is an invaluable seminar for any staff member of your ASC. MORE
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Save the date for ASCA’s 2015 Winter Coding Seminar, January 22-24, 2015, in San Diego, to ensure that your ASC is prepared for 2015’s coding and billing changes. This two-and-a-half day conference is a "must" when it comes to learning best coding practices that assure you receive the reimbursements you have earned. MORE
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The use of data analytics in hospitals and health systems has picked up steam over the past few years as the industry has moved toward value-based, accountable care reimbursement models. As the ASC industry feels the effect of this transition and moves closer to the establishment of its own value-based purchasing system, the use of analytics will become increasingly important. MORE
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Last week, ASCA submitted a letter to the editor in response to the article “Like Priceline for Patients: Doctors Compete for Business via Online Bids for Surgery,” which ran in The Washington Post, Kaiser Health News and other news outlets. Kaiser Health News has published the letter online. MORE
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Simplify your business office operations. Surgical Notes is a nationwide provider of transcription, coding, and document management applications. The ASC industry’s largest management companies and roughly 20,000 healthcare providers trust Surgical Notes to provide customer-focused solutions that eliminate manual processes, streamline workflow, and accelerate the revenue cycle. Visit us at www.surgicalnotes.com or call 800-459-5616 today!



We're here for you.
It's a simple concept, but how many partners answer your questions and help guide you in your quest to manage your revenue cycle? LaClaro is always here to answer questions, offer guidance, and make sure your team has the data it needs to make better decisions for your facility.

Voyance, ASCA’s partner in the ASCA Benchmarking program, is now part of Symphony Performance Health (SPH). The company will continue to partner with ASCA on this program. Look for its new name and logo on any new ASCA Benchmarking materials you receive. MORE
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ASCs from around the country have been showing legislators, government officials, dignitaries, and industry stakeholders the high-quality care ASCs provide as part of National ASC Day. The Christus Cabrini Surgery Center in Alexandria, Louisiana, hosted US Representative Vance McAllister (R-LA) and the Hudson Valley Center for Digestive Health in Cortlandt Manor, New York, hosted representatives from the American Cancer Society, the Hudson Valley Chamber of Commerce, local media and Frank Catalina, mayor of the city of Peekskill. MORE
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Support Excellence in Your ASC
Register for ASCA’s 2014 Fall Seminar, October 9-11, in Scottsdale, AZ. Get innovative solutions and state-of-the-industry advice for improving clinical care, business office management, materials management and your ASC’s bottom line. Attend one, two or all three days of the seminar. Early registration discounts end August 31.



Earn Your Continuing Education Credits
Get the insider information and real-world solutions you need to navigate the regulatory and accreditation requirements, billing and coding changes and clinical and operational concerns you face in your ASC every day by signing up now for ASCA’s 2014 Webinar Series. ASCA members save $50 on each webinar.



Save the Date for ASCA 2015
Mark your calendar for next year’s annual meeting, May 13-16, 2015. ASCA 2015 will take place at the Orlando World Center Marriott Resort & Convention Center. The hotel, just five minutes from Disney World, boasts 10 restaurants/lounges, 18-hole championship golf, a rejuvenating spa and a dedicated children’s splash park.

Industry News


Changing Priorities Shift Hospital Focus to Outpatient Strategies
Healthcare Finance News (08/25/14) Zaino, Jennifer

Greater efficiencies and increased consumer demand are among the factors behind a shift from hospitals to outpatient settings. Same-location revenues at ambulatory service centers have been increasing since 2007, according to a 2013 Moody's Investors Service report, while hospitals have seen a 0.22 annual decline in same-facility inpatient surgeries. "Many revenues that used to be generated from an inpatient setting are being diverted to outpatient settings," said Brad Spielman, vice president and senior credit officer at Moody's Investor Services. The shift comes as more consumers look to receive services at the lowest price point, insurers and government payers focus on controlling health care costs, and health care services advance. Steve Kennedy, managing director at Lancaster Pollard, said "there is greater efficiency in being able to treat certain illnesses and complete certain procedures that negate the necessity of having so many inpatient stays as before."
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Effect of Minimally Invasive Surgery on the Risk for Surgical Site Infections
JAMA Surgery (08/20/2014) Gandaglia, Georgio; Ghani, Khurshid R.; Sood, Akshay; et al.

Minimally invasive surgery (MIS) is significantly associated with a reduced risk of postoperative surgical site infections (SSIs), according to new research. The study looked at four procedures--appendectomy, colectomy, hysterectomy, and radical prostatectomy--in the American College of Surgeons National Surgical Quality Improvement Program database between 2005 and 2011. The researchers abstracted the 30-day SSI rates for patients undergoing open procedures and MIS. According to the data, the overall 30-day rates of SSIs were 5.4 percent for appendectomy, 12.1 percent for colectomy, 2.8 percent for hysterectomy, and 1.7 percent for prostatectomy. The rates of postoperative SSI in patients undergoing MIS compared to open procedures were lower for all four procedures after propensity score matching.
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WHA: Wisconsin Consumers Can Connect to Healthcare Price Info at WiPricePoint.org
Wisconsin Health News (08/21/2014)

The Wisconsin Hospital Association Information Center, LLC (WHAIC) has teamed up with health care providers in the state to further develop and refine tools to help consumers compare health care costs. WHAIC has unveiled an updated version of PricePoint, its Web-based platform that provides facility-specific charges and financial data for all Wisconsin hospitals, urgent care settings owned by hospitals, and Medicare-certified ambulatory surgery centers. WHAIC developed and launched PricePoint in 2005, and the platform is now licensed for use in 10 states.
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Certificate of Need: An Outdated Law in Need of Repeal
NCSPIN.com (08/15/2014) Restrepo, Katherine

A recent report indicates that an increasing number of surgeries are being performed in North Carolina's Raleigh/Durham/Chapel Hill area as Baby Boomers age. The rise in demand is leading to more procedures conducted in outpatient settings, such as ambulatory surgery centers. But North Carolina's outdated Certificate of Need (CON) law imposes rigid rules on health care providers seeking to expand or build facilities or offer innovative services, according to this opinion piece. Fifteen states have already scrapped their CON programs. A study by the Mercatus Center suggests that CON programs should require more evidence from regulators before restricting competition in health care markets.
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Retrospective Analysis of Effectiveness and Safety
BMJ (08/12/14) Poeran, Jashvant; Rasul, Rehana; Suzuki, Suzuko; et al.

A recent study examined the effectiveness and safety of perioperative tranexamic acid use in patients undergoing total hip or knee arthroplasty in the United States. Researchers used the Premier Perspective database, which contains information on surgical hospital discharges from January 2006 to October 2012. Of a total of 872,416 total hip and knee arthroplasty procedures at 510 hospitals, the use of tranexamic acid was significantly associated with an up to 69 percent reduction in the need for allogeneic or autologous blood transfusions. Its use was not associated with an increased risk for perioperative complications, such as thromboembolic events and acute renal failure. In a univariable context, the use of tranexamic acid was linked lower costs of hospital stay, lower rates of advanced care need, and shorter length of hospital stay.
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CMS Database Fails to Accurately Track RAC Activity
Health Data Management (08/14) Slabodkin, Greg

A report from the Government Accountability Office (GAO) says that the Centers for Medicare & Medicaid Services (CMS) lacks reliable data and sufficient oversight to track Recovery Audit Contractor (RAC) program activity and prevent RACs from duplicating post-payment claims reviews. The Recovery Audit Data Warehouse, intended to track RAC activities, is not reliable because Medicare post-payment review contractors do not consistently enter information about their reviews, according to the report. "CMS has not provided sufficient oversight of these data or issued complete guidance to contractors on avoiding duplicative claims reviews," says the GAO, which recommends that CMS monitor the database to ensure all Medicare post-payment review contractors submit the required data to improve efficiency and effectiveness.
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The Best Paying Jobs of 2014
CareerCast.com (08/13/2014)

Surgeons are the highest paid U.S. workers, with an average annual salary of $233,150. according to a new report from CareerCast. Many surgeons focus on various STEM (science, technology, engineering and math)-related specialties that may impact their income significantly. For example, a PayScale.com study reveals that neurosurgeons earn an annual median salary of about $340,000. CareerCast noted that seven of the 10 highest-paying jobs are in the health care arena and require completion of a secondary degree.
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N.C. Insurers to Play a Larger Role in Where You Have Surgery
Triangle Business Journal (08/08/14) deBruyn, Jason

An increasing number of surgeries in North Carolina will migrate away from the conventional hospital setting and into outpatient surgery centers, according to projections by the Triangle Business Journal. An estimated three out of every four surgeries in the Raleigh, Durham, and Chapel Hill area will occur in ambulatory surgery centers. "I believe we are only on the cusp of patients being directed by their payers to the sources that are most value driven," says Carolyn Knaup at WakeMed Health & Hospitals in Raleigh. Economist David Ridley at Duke Fuqua School of Business concurs, saying that insurers are at risk of receiving pushback from patients as they furnish more quality and cost information for people.
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Industry Supports Push of For-Profit Disclosures
InsuranceNewsNet.com (08/20/14) Fitzgerald, Beth

New Jersey Health Commissioner Mary O'Dowd believes that for-profit hospitals should disclose their yearly financial statements to the public, similar to nonprofits. O'Dowd made the recommendation in a hospital financial transparency report, and she said that if hospitals do not voluntarily comply, her department could issue rules making reporting mandatory. Thomas B. Considine, chief executive of the for-profit Meadowlands Hospital Medical Center in Secaucus, N.J., said such disclosure should cover the entire health care sector, including health insurers, large physician practices, and companies that operate ambulatory surgery centers statewide.
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CMS to Withhold One-Third of Provider Data as Open Payments Website Problems Mount
Modern Healthcare (08/18/14) Tahir, Darius

The Centers for Medicare and Medicaid Services (CMS) has brought the Open Payments review website back online after it temporarily suspended registration for the site amid reports that information about the payments doctors received from medical device and drug companies is being commingled. In one case, data about the payments made to two doctors with the same name was combined. However, about one-third of the payment data remains commingled, CMS is reporting. That data is not fit for publication on the Open Payments website, the agency says, and will be withheld until June 2015. Manufacturers and group purchasing organizations will have to correct and resubmit their data at a later time, though it is uncertain when the deadline for doing so will be. CMS says the site will still be made accessible to the general public on Sept. 30 as scheduled, but the agency is giving doctors and teaching hospitals until Sept. 8 to review the payment reports on the site.
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Health Care Data Breaches Have Hit 30M Patients and Counting
Washington Post (08/19/14) Millman, Jason

Since the adoption of federal reporting requirements, the number of health care data breaches has risen significantly, with about 944 incidents affecting personal information from about 30.1 million people, says the U.S. Department of Health and Human Services (HHS). Most of these records have been stolen, affecting 17.4 million people, followed by data loss (7.2 million people), hacking (3.6 million) and unauthorized access accounts (1.9 million people), according to a Washington Post analysis of HHS data. However, the recent theft of 4.5 million medical records from Community Health Systems, allegedly perpetrated by Chinese hackers, is not included in those totals. HHS also said that in 2012, there were 21,194 smaller breaches affecting 165,135 people, similar to reports from 2011. The Ponemon Institute estimates that data breaches cost the health care sector $5.6 billion annually. Moreover, the Identity Theft Resource Center found that 43 percent of major data breaches last year involved healthcare data, topping the group's annual list of targets. However, the group says the increase in breaches could be tied to stricter reporting standards, and it cautions that breaches do not necessarily mean patients are at risk for identity theft.
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