ASCA News Digest (December 23, 2014)

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December 23, 2014





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ASCA Highlights


Revised ASC Quality Reporting Specifications Manual

The Centers for Medicare & Medicaid Services (CMS) has released an addendum for the ASC Quality Reporting Specifications Manual version 4.0, effective for implementation beginning January 1, 2015, and continuing through September 30, 2015. This addendum provides updates based on the OPPS/ASC Final Rule 2015. MORE
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The Medicare Payment Advisory Commission (MedPAC) concluded their last meeting of 2014 last week, proposing a recommendation that the ASC payment increase be eliminated in 2016. The commission also proposed a recommendation that ASCs be directed to report cost data. MedPAC will vote on these recommendations in January. MORE
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Registration is now open for ASCA's Medical Director Leadership Seminar, May 16–17, in Orlando. The new meeting is targeted exclusively to the unique interests and needs of medical directors and other physician leaders in the ASC setting. Register online today—ASCA members can register for a discount and can enjoy additional savings by sending more than one employee. MORE
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Learn how to answer the new financial questions in ASCA's Clinical and Operational Benchmarking Survey accurately and how to apply what you learn from the survey's report to bring about operational improvements in your ASC during ASCA's next webinar on Tuesday, January 13. ASCA Benchmarking subscribers can participate for free! MORE
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The digital edition of the January issue of ASC Focus is now available. Read the latest issue for advice for moving patients and procedures from HOPDs into ASCs, how to manage ASC staff to ensure full coverage, what ASCs need to know about pregnancy discrimination and what you need to know to successfully report ASC-8. MORE
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ASCA members who purchase the 2015 ASCA Benchmarking survey before January 1, 2015, can save 10% off the total price. ASCA Benchmarking is ASCA's online clinical and operational benchmarking program that produces valuable data about your ASC that you can use to improve quality, boost performance and meet the expectations of regulators, payers and patients. MORE
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With only 234 bills signed into law (down 18% from the previous Congress), the 113th Congress will be remembered as one of the least productive Congresses ever. The session closed with a last minute vote to keep the federal government open through September 2015, pushing most major policy discussions until the next session of Congress. MORE
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Industry News


Independent Physicians Under Attack, Says Doctor
Marietta Daily Journal (12/21/14) Gillooly, John

Dr. Mark Huffman, an anesthesiologist based in Marietta, Ga., warned state lawmakers on Dec. 16 that independent physicians are facing a number of pressures. Speaking before the Cobb Legislative Delegation, Huffman urged lawmakers to overhaul the state's Certificate of Need laws to allow independent physicians to launch surgery centers "without spending millions of dollars which these hospitals are willing to spend to keep all the surgery beds in their hospitals." He also urged lawmakers to set a cap on how many physicians a hospital can own and to create incentives to encourage doctors to remain independent, such as loan forgiveness and tax write-offs.
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Ohio Wins $75M to Test New Billing Model to Improve Health Care While Lowering Costs
Cleveland.com (12/18/14) Higgs, Robert

Ohio has been awarded $75 million over the next four years by the U.S. government to test a new billing model for medical care. The model was developed over 18 months of talks involving the state, medical providers, and Ohio's four largest health insurers: Anthem, Aetna, United Healthcare, and Medical Mutual. The plan will focus on quality of care rather than quantity of services to reduce costs and enhance care. Physicians will be encouraged to promote preventive care. In addition, specific conditions--perinatal care, asthma acute exacerbation, COPD exacerbation, percutaneous coronary intervention, and joint replacements--will be targeted, establishing cost estimates for a diagnosis and all procedures.
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House Committee in Favor of Oct. 1, 2015, for ICD-10 Deadline
Healthcare Informatics (12/11/14) Perna, Gabriel

House Energy and Commerce Committee Chair Fred Upton (R-Mich.) and House Rules Committee Chair Pete Sessions (R-Texas) recently voiced their support for keeping the upcoming deadline for ICD-10 transition as Oct. 1, 2015. They expressed their support for the transition deadline in a joint statement saying they intend to "continue our close communication with the Centers for Medicare and Medicaid Services to ensure that the deadline can successfully be met by stakeholders," calling it a "milestone in the future of healthcare technology." Upton and Sessions say they heard from several interested parties worried about falling behind after the latest delay of ICD-10 and say that moving forward with the transition is a priority. The statement is a further indication of a lack of congressional support for further ICD-10 delays.
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Doc Database May Soon Include CME-Related Payments
Modern Healthcare (12/15/14) Lee, Jaimy

On Dec. 15, the Centers for Medicare & Medicaid Services (CMS) revised part of the Open Payments database to require manufacturers to report information about payments made for continuing medical education (CME) activities. The CMS says such payments must be reported if the manufacturer is aware of the name of a physician paid to speak at a CME event the company funded within the reporting year or by the second quarter of the following reporting year. Reporting of payments made for accredited CME activities could start in 2016, says Dr. Daniel Carlat, former director of the Prescription Project at Pew Charitable Trusts, and that data could then be released to the public in 2017, according to CMS.
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athenahealth Announces Results of 9th Annual Epocrates Future Physicians of America Survey
MarketWatch (12/15/14)

The ninth annual Epocrates Future Physicians of America survey found that the percentage of medical students who plan to seek employment with a hospital or large group practice increased to 73 percent, while those who favor private practice comprise just 10 percent. In explaining their responses, students cited a desire for work-life balance and low administrative hassle in the work environment. Nearly 60 percent of medical students expressed dissatisfaction with the training they received related to practice management and ownership, billing, and coding. In addition, 96 percent of students felt that high quality care requires effective collaboration with extended care teams, while nearly 60 percent said lack of communication between care teams is the main hurdle to effective care coordination.
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Connecticut Insurers Share Facility Fee Concerns With Lawmakers
New Haven Register (12/18/14) O'Leary, Mary

Insurance executives recently told Connecticut lawmakers that efficiencies promised by hospital mergers have not occurred, and the purchase of physician offices has not led to lower costs. Speaking at the Bipartisan Roundtable on Hospitals and Healthcare, William Welsh, associate chief counsel at Cigna, said his company has seen significant cost increases attributed to hospital consolidations. He said the claims of a patient who was on a drug regimen for cancer before and after his physician's practice was purchased by a hospital revealed that the average unit cost for the patient's cancer drug was $6.90 before the purchase and $413 after. Similarly, the cost for colonoscopies and endoscopies increased significantly when practices were purchased compared with independent offices not affiliated with a hospital. The average cost for the independent group was $1,400, while those affiliated with a hospital charged $3,300.
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Consumers Sorely Lacking Information on the Quality of Their Doctors According to Latest HCI3 Research
HCI3 (12/16/2014)

A study by the nonprofit Health Care Incentives Improvement Institute (HCI3) found that Americans have access to objective quality data for only 16 percent of physicians in the United States, and some states have no data available. HCI3 graded the states based on publicly available quality information, the type of measurement provided, and the accessibility of the information to consumers. The states that received passing grades had all implemented Aligning Forces for Quality programs, either at a regional or statewide level. "Consumers are flying blind when it comes to selecting hospitals and physicians, and the overall quality and affordability of American health care won't be improved until we find a way to solve this problem," says Francois de Brantes, HCI3 executive director. For the second year in a row, only two states received an A grade--Minnesota and Washington State--while the majority received failing grades.
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Higher-Earning Physicians Order More Services
Medscape (12/10/14) Hand, Larry

Higher-earning physicians are paid more because they provide more services per person rather than see more unique patients, according to data from the Centers for Medicare & Medicaid Services. Researchers at the University of California, Los Angeles, and the Veterans Health Administration examined the government's recently released data and discovered a wide range of physician payments indexed to unique patients. "These findings suggest that the current health care reimbursement model--fee-for-service--may not be creating the correct incentives for clinicians to keep their patients healthy," said Jonathan Bergman, one of the authors of the research letter in JAMA Internal Medicine. The researchers encouraged physicians to migrate to patient-centered care, saying that more research was needed to determine if the extra services are actually helping improve quality of care.
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Midwest Bone and Joint Institute Becomes First in the State to Offer Total Hip Replacement in Outpatient Setting
PR Newswire (12/15/14)

In Illinois, patients with hip pain now have a minimally invasive alternative to traditional hip replacement surgery. Dr. Shawn W. Palmer of Midwest Bone and Joint Institute recently performed the state's first outpatient anterior approach hip replacement surgery at Valley Ambulatory Surgery Center in St. Charles. The surgery may cost up to 66 percent less when performed in an ambulatory surgery center, resulting in savings of thousands of dollars for patients. Dr. Palmer said advances in pain control and minimally-invasive surgery make it possible to offer the surgery in an outpatient setting. Although the procedure is not suitable for every patient, the benefits are significant, he says, citing less pain and the ability to recover better at home.
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