ASCA News Digest (December 2, 2014)

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December 2, 2014





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ASCA Highlights


Register for Today's Webinar, "CPT Changes for 2015," at 1pm ET

Get up to date on the new, revised and deleted CPT codes that will affect ASCs in 2015 by registering for today's webinar, "CPT Changes for 2015." Cristina Bentin, president of Coding Compliance Management, LLC, will cover applications and scenarios for reporting the new codes, as well as reimbursement potentials from a CMS perspective. CEU and AEU credit is available. MORE
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Do you or someone you know have an interest in helping to advise Congress on Medicare payment policy? ASCA is calling for nominations to the Medicare Payment Advisory Board (MedPAC), which is an independent congressional agency charged with advising Congress and the US Department of Health & Human Services (HHS) on Medicare payment policies, patient access and quality of care. MORE
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Resources to assist ASC operators in determining the impact of Medicare’s 2015 payment changes are now available on ASCA’s web site. These resources include ASCA’s Medicare Rate Calculator, a list of the procedures classified as office-based for 2015 and an updated list of device-intensive codes with payment rates. MORE
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ASCA has partnered with HealthStream to offer a collection of 21 courses that apply specifically to ASCs and are designed to train ASC staff on the most current regulations and standards of care. 16 of the interactive courses provide continuing education (CE) credit. Reduced prices are available through January 31, 2015. MORE
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CMS is hosting a free webinar regarding the 2015 final ASC payment rule and the requirements for the ASC Quality Reporting Program that will affect 2016 and subsequent years’ payment determination criteria. The webinar will take place Friday, December 5, and two sessions will be offered at 10:00 am and 2:00 pm ET. MORE
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Industry News


Doctor Shortage Looming? Maybe Not
NPR Online (11/18/14) Rovner, Julie

An increasing number of experts are questioning the claim that the United States is facing a critical shortage of doctors that could imperil patients' ability to obtain medical care in coming years. Health economist Gail Wilensky and a colleague recently led a panel that looked at the funding of advanced training for doctors. Nonphysician primary care providers--such as physician assistants, nurse practitioners, and pharmacists--typically work in teams with a medical doctor and may provide more cost-effective care, according to some health policy analysts. Wilensky says nonphysician health practitioners provide a different set of services that can potentially reduce the need for more primary care doctors. There is also a consensus that the United States should stop paying physicians based on the number and type of treatments performed and instead base payment on how well they keep patients healthy.
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Battle of the Expenses: AMA Defends High Estimates of ICD-10 Transition Costs
Healthcare Dive (11/26/14) Zieger, Anne

The American Medical Association (AMA) is challenging the results of a new study by 3M Health Information Systems that estimates the cost of the ICD-10 migration. The 3M study predicts that implementing ICD-10 would cost small practices between $1,960 and $5,900, while a study by AMA and Nachimson Advisors projects that the switch would cost small practices between $22,560 to $105,506. The AMA says the 3M estimate fails to take into consideration several implementation components, such as training, assessment and planning, engaging vendors, internal and external testing, and process updates. The 3M projection is lower because it assumes that costs related to electronic medical record adoption and other health care initiatives are not directly related to ICD-10, that today's coders are better prepared for the switch, and clinician documentation and coding training tools are less expensive.
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For Consumers, Health Care Cost and Quality Information Remains Hard to Find and Understand
Minneapolis Star Tribune (11/22/14) Spencer, Jim

The U.S. Government Accountability Office (GAO) recently sought to obtain information on health care costs and quality data in several areas across the country. Minnesota and Oregon were selected because both states have programs intended to make it easier for consumers to access information about what providers charge for care. In addition, Minnesota has a law that "requires providers to make estimated costs of treatment and estimated costs that must be paid by the patient available upon request," the GAO said. But when GAO staff members posed as patients to ask about the cost of common hernia repairs or colonoscopies in the Minneaplis-St. Paul area, half could not get answers, while some others received an extremely wide range of price quotes. "We were trying to put on the face of a consumer," says Linda Kohn, who directs the GAO's health care team. "The takeaway is that it is pretty hard to get this information." Kohn declined to identify the Minnesota ambulatory surgery centers and outpatient facilities that were surveyed. The GAO report recommends changes to the Centers for Medicare & Medicaid Services website to which many consumers are directed for comparative health care information.
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Amherst Eye Doctor Performs Free Surgery on 11 Patients Without Insurance
Buffalo News (11/15/14) Sommer, Mark

Over the past few years, Dr. Kenneth Anthone has performed about 100 free cataract surgeries in the Buffalo, N.Y., area for people who could not afford them due to a lack of health insurance. This year, he performed 11 surgeries for the sixth annual "Mission Cataract Day," sponsored by Eyes On America Foundation. Anthone says that the average cost of cataract surgery is about $1,000. He expects to do more free surgeries next year, thanks to the success of a recent Eyes On America fundraiser, and is discussing a possible partnership with an ophthalmology group. This way, Anthone says, they may address other forms of eye diseases, such as glaucoma and crossed eyes.
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ECRI Institute Announces Top 10 Health Technology Hazards for 2015
ECRI Institute (11/25/2014)

The ECRI Institute has published its annual list of Top 10 Health Technology Hazards that it considers essential for health care facilities to address in the coming year. The list includes inadequate alarm configuration policies and practices, incorrect or missing data in electronic health records and other health IT systems, and mixing up IV lines leading to misadministration of drugs and solutions. The list also cites inadequate reprocessing of endoscopes and surgical instruments, accidental ventilator disconnections due to mis-set or missed alarms, and complications involving robotic surgery due to insufficient training. ECRI experts have also expressed concern over recall tracking programs that fail to keep pace with the rising number of medical device recalls issued annually. The FDA reports that the annual number of medical device recalls nearly doubled between 2003 and 2012, from 604 to 1,190.
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Insurers' Listings of In-Network Doctors Often Out of Date
Wall Street Journal (11/26/14) P. A3 Beck, Melinda

Insurers' provider networks in their Medicare Advantage and commercial health plans are smaller this year, but physicians and regulators indicate that these networks may be even smaller because the lists are often out of date. These lists often contain duplicate names or physicians who have moved, retired, or died; include physicians under the wrong specialty; or show physicians who work in hospitals full-time, do not see outpatients, or do not accept the plan. Insurers say physicians are required under their contracts to notify them of a location change or their withdrawal from a plan, but many doctors say insurers are not responsive to complaints about inaccurate listings and even continue to list them in provider directories after dropping them from the network. Meanwhile, the Centers for Medicare & Medicaid Services says, "Medicare is reviewing areas of the country experiencing provider contract terminations to ensure that beneficiaries have complete and timely information and access to needed care."
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Quiet Launch for Potentially Practice-Changing Technology
Gastroenterology & Endoscopy News (11/14) Vol. 65, No. 11 Marcus, Adam

Clinicians at Virginia Mason Medical Center in Seattle have become early adopters of the new Sedasys system for propofol delivery. The automated technology delivers light to moderate sedation for patients undergoing colonoscopy or esophagogastroduodenoscopy and monitors the effects of the anesthetic in real time. The device, which has won federal government approval, reduces the risk of oxygen desaturation occurring and the severity of the condition in cases where it does. It has demonstrated an ability to bring patients out from sedation quickly--within 10 minutes for 99 percent of patients. Virginia Mason's Otto Lin, MD, believes using Sedasys could revolutionize gastroenterology offices, at least those who work in a clinical setting with anesthesiologists on hand. Because they do not have to be present when the system is in use, however, Lin says, "It really allows us to use propofol, which we believe is superior to midazolam and fentanyl, in outpatients without having the added costs of having anesthesiologists administer [the drug]."
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Northstar Acquires Premier National Healthcare Marketing Company for $34 Million
MarketWatch (12/01/14)

Northstar Healthcare Inc. has acquired Athas Health for $34 million in cash and stock. Athas, based in Dallas, focuses on the marketing and delivery of specialized health care services across seven states. "Athas' revenue model has historically captured approximately 50 percent of their partner facility's collections," says Harry Fleming, Northstar's president. "Northstar surgery centers will now have the opportunity to capture all of these revenues that were formerly directed to competing surgery centers."
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Bascom Palmer Opening New Eye Surgery Center in North Naples
Naples Daily News (FL) (11/25/14) Freeman, Liz

A $25 million building is being built by Bascom Palmer Eye Institute of Miami. The 20,000-square-foot medical complex and surgery center in Naples, Fla., is expected to open in June, according to medical director Dr. Stephen Schwartz. "It may take a little longer to get the surgery center certified," he says. The new, two-story building will allow Bascom Palmer to offer comprehensive eye and specialty care for retinal and macular diseases, corneal and external diseases, ophthalmic plastic surgery, neuro-ophthalmology, glaucoma, and pediatric ophthalmology. The second floor will have six exam rooms and an ambulatory surgery center with two operating rooms. Schwartz estimates that the complex "could easily double patient visits to 28,000 patient visits."
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