ASCA News Digest (February 4, 2014)

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February 4, 2014





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ASCA Highlights


HIPAA in Plain English: Compliance, Tips and Case Studies

Failing to comply with the HIPAA Privacy and Security Regulations can severely damage a provider's reputation and lead to crippling sanctions and penalties. Are you confident that you understand the many ways HIPAA applies to your ASC? Get practical compliance advice you can use daily and learn everything you need to know about HIPAA during ASCA's next webinar. MORE
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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.

We simplify ASC management.

We simplify ASC management. SourceMedical is the leading provider of software and billing services for Ambulatory Surgery Centers and Specialty Hospitals nationwide. For nearly 30 years, SourceMedical has stood as the trusted brand for innovative applications, industry expertise and unsurpassed customer service. To learn more, visit www.sourcemed.net.

ASCA Benchmarking subscribers: the deadline to submit data for the fourth quarter (Q4) of 2013 has been extended through this Friday, February 7. Not only does this change apply to this year's survey, but Q4 data submission will be extended through the first week of February for all future surveys as well. MORE
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With health care legislation creating fluctuations in reimbursement rates, many ASC owners are weighing their options. Mounting pressure caused by inconsistent reimbursement rates has caused an increase in the number of hospital acquisitions of ASCs and the subsequent conversion of ASCs to HOPDs. MORE
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Tell your ASC’s story of patient-centered care directly to members of Congress this June and September by attending ASCA’s 2014 Capitol Fly-In Program. Thanks to contributions from the ASCA Advocacy Fund, the first 50 registrants will save $50 on their hotel room. MORE
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The FDA is aware of the shortage situation for intravenous (IV) solutions, particularly 0.9% sodium chloride injection. The FDA is working with manufacturers to alleviate the shortage and it is expected to be over by the second quarter of 2014. MORE
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Industry News


New Outpatient Surgery Center Developing Clear-Cut Cost Analysis
Charlottesville Daily Progress (VA) (02/01/14) McKenzie, Bryan

Doctors at Monticello Community Surgery Center, a Charlottesville, Va., outpatient facility that is set to open in March, have developed a straight-forward fee system to let patients know the exact cost of their surgery. The center's physicians say they will provide cost assessments that outline all fees. Information on the cost of an operation will be available on the center's Web site, says Dianne Simmons, the center's administrator. "The regular payment system is in place for those patients in traditional plans," says Simmons. "A lot of employees with health savings accounts do not have employer contributions so they are funding a lot of their own medical care. When that's the case, it's important to know the full price up front."
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Study: Patients Feel Safer When They Receive Surgical Safety Checklist
News-Medical.Net (01/25/14)

When patients get actively involved in using the World Health Organization Surgical Safety Checklist (SSC), the rate of complications goes down. In a pilot study, researchers at Tulane University Hospital and Clinic discovered that surgical teams were more likely to use the the quality improvement tool when patients were informed about it and requested caregivers to adhere to it. SSC compliance was measured for 61 patients who were unaware of the resource, along with 43 who were provided a copy of the list and an explanation of its purpose. Compliance rose for all 26 checklist items among the informed group, including confirmation of patient allergies prior to anesthesia and verification of surgical site before incision. For one metric--assurance that sponges and other instruments are accounted for before the patient leaves the operating room--the difference in compliance levels between informed and uninformed patients was 87 percent versus 19 percent. "The checklist is only beneficial when it is used," said Dr. Seth Christian, of the hospital's anesthesiology department, "and we found that involving patients helps ensure that surgical teams complied with it."
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Minnesota Sees Encouraging Progress at 10-Year Anniversary of Hospital Safety Effort
Minnesota Department of Health (01/23/2014)

Two new reports marking the 10th anniversary of Minnesota's Adverse Health Events reporting system indicate that, overall, the effort has been a success. The system monitors 28 types of serious events--including wrong-site surgeries, severe pressure ulcers, falls, and medication errors--at hospitals and ambulatory surgery centers in the state. The Adverse Health Events Report tracked 258 adverse events that were recorded between October 2012 and October 2013, an 18 percent decline from the previous year. There were 84 adverse events that resulted in serious disability, down from nearly 100 in 2008, but there were 15 deaths, 10 of which were related to falls. Findings from the 10-Year Adverse Health Events Evaluation Report indicate that hospitals and surgery centers have increased their awareness of patient safety and are generally safer than they were a decade ago, with fewer adverse health events related to surgeries and invasive procedures, such as wrong-site surgeries and objects left in patients after surgery.
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The 10 Most Expensive Insurance Markets in the U.S.
Kaiser Health News (02/03/14) Rau, Jordan

The 10 regions of the country--ranging in size from a single county to an entire state--with the highest premiums for the lowest price "silver" plan sold on the new health insurance marketplaces have been compiled, based on rates listed on the exchanges and data collected by the Kaiser Family Foundation. The least expensive silver plans--which most consumers are selecting--cost $483 in the Colorado Mountain Resort Region; $461 in Southwest Georgia; $456 in rural Nevada; $445 in far western Wisconsin; $423 in southern Georgia; $405 in most of Wyoming; $399 in southeast Mississippi; $395 in Vermont; $383 in Fairfield, Conn.; and $381 in Alaska.
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HealthCare.gov Can't Handle Appeals of Enrollment Errors
Washington Post (02/02/14) Goldstein, Emily

Internal government data obtained by The Washington Post reveals that approximately 22,000 Americans have filed appeals with the federal government to correct errors related to the federal online insurance marketplace. These consumers say HealthCare.gov charged them excessively for health insurance, directed them to incorrect insurance programs, or completely denied them coverage. People familiar with the situation say HealthCare.gov's computer system is not yet allowing federal workers to access enrollment records in order to change them.
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Joining GOP Trend, U.S. Chamber of Commerce Urges Fix, Not Repeal, of Obamacare
Kaiser Health News (01/31/14) Whitney, Eric

The U.S. Chamber of Commerce and other business lobbying groups are now focusing on revising specific parts of the Affordable Care Act rather than eliminating the entire law. Chamber President Tom Donohue said recently, "We're not going to get rid of that bill, and so we're going to have to devise ways to make it work." One item the Chamber wants thrown out is a measure that states that, starting in 2015, employers with more than 50 workers must provide health insurance to employees or pay a fine.
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Medicare's Delivery System Reform Initiatives Achieve Significant Savings and Quality Improvements--Off to a Strong Start
HHS News Release (01/30/14)

The Centers for Medicare & Medicaid Services (CMS) has released its findings on various initiatives to overhaul the health care delivery system, including assessments of Medicare Accountable Care Organizations (ACOs). Interim financial results released for the Medicare Shared Savings Program ACOs reveal that in their first 12 months, nearly half (54 out of 114) of the ACOs that started program operations in 2012 already had lower expenditures than anticipated. In addition, an independent initial assessment of the Pioneer ACO Model revealed that Pioneer ACOs generated gross savings of $147 million in their first year while continuing to deliver high quality care. This ACO model is designed for more experienced organizations prepared to take on greater financial risk. Meanwhile, CMS also announced that 232 acute care hospitals, skilled nursing homes, physician group practices, long-term care hospitals, and home health agencies have entered into agreements to take part in the Bundled Payments for Care Improvement initiative to better coordinate care for patients while in the hospital and after they are discharged.
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Strong Makes Case for Brockport Surgery Center
Rochester Democrat & Chronicle (NY) (01/28/14) Singer, Patti

The University of Rochester Medical Center (URMC) hopes to launch a new outpatient surgery center in Brockport, N.Y., potentially as soon as late summer, according to Betsy Slavinskas, director for ambulatory care at URMC. The initiative first must be approved by the state's Public Health and Health Planning Council, which is scheduled to vote on the proposal on Feb. 13. An application submitted to the New York State Department of Health by URMC reveals that the planned Strong West Ambulatory Surgery Center would be open from 7 a.m. to 6 p.m. Monday through Thursday and have three operating rooms and one procedure room. Surgical specialties anticipated to be offered as the center include orthopedics, ophthalmology, podiatry, general surgery, and endoscopic procedures like colonoscopies.
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Waivers Pave Way for Medicaid Expansion in Some States
USA Today (01/27/14) Ollove, Michael

The federal government's waiver process allows states to revise their approach to Medicaid, such as by extending Medicaid eligibility or covering more health services. Arkansas and Iowa, for instance, have sought permission to use Medicaid funds to purchase private insurance on the new state insurance exchanges for the expansion population. Ideally, program changes from waivers should not cost more than the federal government's contributions, but if they do, the state has to find ways to offset the increased spending. The U.S. Department of Health and Human Services recently took steps to standardize the waiver process for states.
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What Deadline? Most Americans Unaware of ObamaCare Deadline
Fox Business (01/27/14) Rogers, Kate

A recent survey of more than 1,000 adults by Bankrate.com reveals that 55 percent of respondents are unaware of the March 31 deadline to enroll in health coverage under the Affordable Care Act. The survey shows that 24 percent of those polled think the deadline passed on Jan. 1, while 11 percent believe enrollment ends at the end of the year. Those who miss the deadline and do not have coverage by April 1 will have to pay a penalty and wait until the 2015 open enrollment period to buy insurance.
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NAACOS Releases Results From First Ever Survey of ACO First Year Start-Up Costs and IT Spending
National Association of ACOs (01/22/2014)

The National Association of ACOs recently conducted its first short online survey on issues faced by the 2012 Medicare Shared Savings Program's accountable care organizations (ACOs). A total of 35 ACOs that finished their first full year of operation took part, with sizes ranging from 5,100 to 78,000 assigned Medicare beneficiaries. The survey revealed that the average first 12 months start-up cost per ACO was $2 million. However, savings were slow to migrate due to the data and complex reconciliation process, so ACOs will have to assume the risk of almost a second full year of operations before their cash flow can be replenished with shared savings from CMS, if any. The majority of the ACOs surveyed expect to break even, with aggregate program losses offsetting nearly all the gains.
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