ASCA News Digest (February 11, 2014)

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February 11, 2014





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ASCA Highlights


Subscriptions Now Available for 2014 ASCA Benchmarking Survey

ASCA members can subscribe to the 2014 survey for $299 (the nonmember rate is $999). Even if you previously subscribed to the 2013 survey, you will need to purchase a new subscription in order to participate in the 2014 survey. Register today. MORE
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ASCs cannot change our patients’ circumstances, but we can control how we approach patients and care for them, and with that in mind, ASCs can change their patients’ overall experience of the outpatient surgical care that they receive. MORE
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Only a couple of years ago, an ASC in Somers Point, New Jersey was performing one or two American Society of Anesthesiologists (ASA) 4 procedures per quarter. Today it is doing between 12 and 15 per quarter. MORE
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CMS has released an updated list of procedures that subject to the CMS device adjustment policy. This policy, first finalized in the 2009 final rule, reduces payment to ASCs when a specified device is furnished without cost or with full credit or partial credit for the cost of the device for those ASC covered surgical procedures that are specified. MORE
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Renewal notices for 2014 have been mailed to all current ASCA members. We encourage you to renew your 2014 ASCA membership online through the ASCA web site. We thank you for your continued support of ASCA, your membership allows us to provide the advocacy support and resources you need to continue to operate your ASC. MORE
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McDermott Will & Emery’s annual ASC Symposium is a national conference addressing high-level business and legal issues affecting the ASC industry. ASCA is pleased to join co-hosts Jerry Sokul, ASC Symposium program chairman; Michael Guarino, ASCA vice president; and Bill Prentice, ASCA chief executive officer, for a VIP Breakfast to raise awareness and support for advocacy efforts in Washington, DC. MORE
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The coalition advised CMS staff that, while we strongly support quality reporting, ASC-9 and ASC-10 are not indicative of facility-level performance and should be removed from the program. MORE
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Industry News


From Research to Nationwide Implementation: The Impact of AHRQ's HAI Prevention Program
Medical Care (02/01/14) Vol. 52, P. S91 Battles, James B.; Farr, Stacy L.; Weinberg, Daniel A.

The Agency for Healthcare Research and Quality's (AHRQ's) Patient Safety Portfolio examines such things as healthcare–associated infections (HAIs), which impact one out of every 20 hospital patients at any given time. The Patient Safety Portfolio takes into account whether or not planned AHRQ projects addressed one of six HAIs prioritized in the National Action Plan: central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), surgical site infections, ventilator-associated pneumonia, methicillin-resistant Staphylococcus aureus (MRSA), and Clostridium difficile. Priority was also given to the National Action Plan's health care settings, including acute care hospitals, ambulatory surgery centers, end-stage renal disease facilities, and long-term care. AHRQ's HAI prevention research efforts include funding projects to implement the Comprehensive Unit-based Safety Program to address CLABSI, CAUTI, and MRSA nationwide.
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Guidelines for Safety in the Gastrointestinal Endoscopy Unit
Gastrointestinal Endoscopy (01/14) Calderwood, Audrey H. ; Chapman, Frank J.; Cohen, Jonathan; et al.

The American Society for Gastrointestinal Endoscopy (ASGE) has issued new guidelines for safety in the gastrointestinal endoscopy unit, including recommendations for implementing and prioritizing safety efforts and a specific framework with which to evaluate endoscopy units. The Centers for Medicare and Medicaid Services' Ambulatory Surgical Center Conditions for Coverage in 2009 stopped distinguishing between a sterile surgical room and a non-sterile procedure room--meaning that non-sterile procedure environments, including endoscopy units, are required to meet the same standards as sterile operating rooms. "Over the past two years, surveyors have called into question accepted practices at many accredited endoscopy units seeking reaccreditation," the ASGE noted. "Many of these issues relate to the Ambulatory Surgical Center Conditions for Coverage set forth by CMS and the lack of distinction between the sterile operating room and the endoscopy setting." The new guidelines include a summary of issues faced by endoscopy units around the United States as well as the ASGE position on each and the accompanying rationale.
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Predictors of 30-Day Readmission After Outpatient Thyroidectomy. An Analysis of the 2011 NSQIP Dataset
American Journal of Otolaryngology (02/14) Khavanin, Nima; Mlodinow, Alexei; Kim, John Y.S.; et al.

More than 4,500 outpatient thyroidectomies have been performed since 2006, and new research indicates that readmission after the procedure is rare. Using the 2011 National Surgical Quality Improvement Program dataset, investigators identified more than 5,100 patients who underwent an outpatient thyroidectomy that year. Overall, 30-day morbidity was infrequent, with only 0.92 percent of patients experiencing any perioperative morbidity and just 2.17 percent readmitted within 30 days of the procedure. The only preoperative comorbid medical condition that significantly increased a patient's risk for readmission was chronic obstructive pulmonary disease. Patients with surgical or medical complications were more likely to be readmitted. The researchers write, "As procedures continue to transition into outpatient settings and financial penalties associated with readmission become a reality, these findings will serve to optimize outpatient surgery utilization."
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Lawmakers Reach Deal on Doctor Payments
Wall Street Journal (02/07/14) Radnofsky, Louise

The American Medical Association and several other physician groups are coming out in support of a bill unveiled Feb. 6 by leading members of two House and Senate committees that would repeal Medicare's sustainable growth rate (SGR) formula. The bill calls for Medicare to increase physician payments by 0.5 percent each year for the next five years and would provide bonuses to healthcare providers who agree to be reimbursed on the basis of patient outcomes instead of the volume of services they provide. However, it remains unclear how the repeal of SGR would be paid for. The introduction of the SGR repeal bill comes after Congress postponed the scheduled 24 percent cut to Medicare reimbursements by three months in December. Although the issue of how the repeal would be paid for remains up in the air, AMA President Ardis Dee Hoven praised Congress for taking action on the thorny issue of SGR, saying that lawmakers are "closer than ever" to passing a fiscally-responsible bill that would repeal the "fatally-flawed" formula.
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Trinitas Regional Medical Center in Elizabeth Dedicates New Ambulatory Surgery Center
NJ.com (02/04/14)

A new ambulatory surgery center has been formally opened by Trinitas Regional Medical Center at its main campus in Elizabeth, N.J. The 9,500-square-foot, $5.2 million facility features three operating rooms for same-day outpatient surgeries, a recovery area with three bays, a pre-op area, and a step-down area. The facility will function as a part of the existing operating room services at Trinitas. "The beauty of having a hospital-based ambulatory surgery center is that there is immediate access to the full services of the rest of our facility. This is added assurance for our patients who will come to this new center for same-day surgeries," notes Gary S. Horan, president & chief executive officer of Trinitas.
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Insurers Slash Specialty Hospitals to Keep Premiums Low
Bloomberg (02/06/14) Chen, Caroline

To keep premiums low, health insurance companies are eliminating certain hospitals from coverage, particularly specialty care hospitals. The reduction in coverage is a repercussion of the Affordable Care Act, which requires insurers to broaden health benefits, restricts how much premiums can vary with age, and adds a new health-insurance tax. These pressures have caused insurers to narrow networks to those that accept lower payments for higher patient volume. U.S. health care spending is expected to grow 6 percent this year, to $3.1 trillion. The average premium for family coverage has increased 80 percent in the last decade.
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Administration Drills Down to Find the Uninsured
Associated Press (02/05/14) Alonso-Zaldivar, Ricardo

A study conducted for The Associated Press found that half of the nation's uninsured live in just 116 of 3,143 counties, suggesting that a geographically targeted outreach campaign would be effective in increasing enrollment numbers for Obamacare. The study also found that half the uninsured people between the ages of 19 to 39 live in 108 counties. An Obama Administration study conducted by the State Health Access Data Assistance Center at the University of Minnesota found similar results. The administration is working on its close-out campaign to generate additional sign-ups before the March 31 deadline, focusing on 25 key metro areas such as Dallas and Houston, Miami, Atlanta, northern New Jersey, Philadelphia, Detroit, Cleveland, Indianapolis, Nashville, and Charlotte.
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Insurers Eye Market for Supplemental Health Coverage to Fill Gaps Left by Obamacare, Employer Plans
Kaiser Health News (02/05/14) Hancock, Jay

Insurance companies are selling supplemental policies to consumers amid rising out-of-pocket costs and as a way to expand their business. These limited policies pay cash after a hospital stay or particular disease diagnosis, such as cancer. Such products typically cost less and provide fewer benefits than conventional insurance and are comparable to "medigap" coverage for seniors, insurers say. The policies are being promoted as helping pay out-of-pocket costs that can reach thousands of dollars in plans offered by employers and the health law's online marketplace.
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Study: Patients Need Training on New Health Insurance
USA Today (02/03/14) Kennedy, Kelly

A study published in Health Affairs attributes the failure of new Medicaid patients in Oregon to use their benefits effectively on the fact that they did not understand how to use insurance or health care. The researchers determined that these patients used their coverage only for medical emergencies, not to schedule appointments to manage chronic illnesses or receive preventive health screenings. The survey of 120 new Medicaid enrollees found that they did not want to waste taxpayer money, assumed that using their insurance for minor ailments or physicals meant someone else would not receive care, did not understand that preventive screenings result in long-term cost savings, and worried about how much they would be required to pay if they saw a doctor. Sixty percent of those polled did not understand their benefits, and 40 percent did not understand how the program worked.
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SourceMedical and LaClaro Announce Partnership
SourceMedical (02/06/2014)

Source Medical Solutions has entered into a partnership with LaClaro to provide work flow automation tools and advanced management reporting. The partnership will enable surgery centers' back-offices to systematically standardize workflow processes and provide analytics on-demand to SourceMedical clients. All three of SourceMedical's software platforms--Vision, AdvantX, and SurgiSource--are compatible with LaClaro's system.
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