ASCA News Digest (January 22, 2014)

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January 21, 2014





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ASCA Highlights


Are You Using Immediate-Use Steam Sterilization Safely?

Improper immediate-use steam sterilization techniques can put patients and staff at risk of infection and other serious injuries. Are you doing all you should to protect your patients and staff? Find out when your ASC should use immediate-use steam sterilization and what you need to do to meet rules and guidelines during ASCA's next webinar, Tuesday, January 28, at 1:00 pm ET. 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.

The digital edition of the February issue of ASC Focus is now available. Read the latest issue to learn how you can make a difference in policymaking, how to manage bundled payments effectively in your ASC and how to capture cases migrating out of hospitals. MORE
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The data collection period for the fourth quarter (Q4) of 2013 is now open. If you have not purchased a subscription yet, ASCA members can take advantage of a special pro-rated introductory rate. In addition, the reports for the third quarter (Q3) of 2013 are also available online. MORE
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The number of codes that are now packaged, and thus not separately payable, grew significantly as a result of the CMS 2014 ASC Final Payment Rule. Of the 232 codes that are now packaged, 101 of those codes are newly packaged. The complete list of packaged codes, as well as a document that separates out the newly packaged codes, is available on ASCA’s Medicare Payment Resources page. 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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To take full advantage of all the resources that the ASCA News Digest has to offer, make sure that you allow Microsoft Outlook to display the pictures featured in the email every week. Simply right-click on one of the pictures that is not displaying and select "Add Sender to Safe Senders List" or "Add the Domain @ascassociation.org to Safe Senders List." MORE
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ASCA staff spoke with CDC staff earlier this week to discuss the ASC-8 quality reporting measure, “Healthcare Personnel Influenza Vaccination.” CDC staff confirmed that ASC-8 data collection will take place for the influenza season between October 1, 2014, and March 31, 2015, and indicated that other providers who currently report this information must do so by May 15 every year. MORE
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Industry News


Revealing Times: Hospitals, Physicians Face Mounting Policy and Market Pressure to Disclose Prices
Modern Healthcare (01/18/14) Carlson, Joe

Hospitals and physicians are facing increasing calls for price transparency, and the Centers for Medicare and Medicaid Services' (CMS) recent decision to provide information under Freedom of Information Act requests on how much Medicare pays individual physicians is drawing further attention to the issue. One key factor in the growing attention on prices is the rapid increase in the number of individuals who are covered by health plans with high deductibles and coinsurance, as they have to pay more out of pocket and thus need to know which providers have lower prices. To that end, the CMS last year published data showing what hospitals charge and what Medicare pays them for common inpatient and outpatient procedures, while North Carolina passed a law requiring hospitals and ambulatory surgery centers to publish on a state website what they are paid for more than 100 procedures and services. Experts also point out that publishing hospital charge data could lead to a greater discussion about the wide variation in charges among hospitals.
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Quality of U.S. Emergency Room Care Falls, Physicians Say
Bloomberg (01/16/14) Chen, Caroline

In a new report, the American College of Emergency Physicians warns that federal funding for disaster preparedness has declined, making hospitals less prepared to handle a sudden upsurge in injured patients. The report uncovered a wide range in the number of emergency drills conducted from state to state, with Mississippi averaging just 0.1 drills per hospital, while Rhode Island averaged 18.8. The report found that staffed inpatient beds declined 16 percent to 330 per 100,000 people in 2012 from 2009.
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If Congress Changes the Medicare Payment Policy, What Does That Mean for Patients and Doctors?
MedCity News (01/16/14) Carey, Mary Agnes

Physician groups are hopeful that Congress could take action as early as this spring to repeal the sustainable growth rate (SGR), after lawmakers voted in December to extend the current SGR fix until March 31. Among those pushing hard for a repeal is the American Medical Association, whose president, Ardis Dee Hoven, noted recently that "this long-overdue policy change provides the stability that physicians need to pursue delivery innovations that help improve patient care and reduce costs for American taxpayers." One key factor in replacing the SGR, said former Centers for Medicare and Medicaid Services administrator Mark McClellan, is how quickly an effective alternative system can be created. The Congressional Budget Office estimates that repealing the SGR would cost about $116 billion over the next decade--a figure that is much lower than previous estimates, in part due to lower Medicare spending on physician services over the past few years. Although it is still not clear how congressional committees plan to pay for the fix, some legislators and physician groups have previously suggested using funds from the Overseas Contingency Operations fund, discretionary funding for the wars in Iraq and Afghanistan.
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CMS to Release Some Information on Medicare Payments to Physicians
Health Data Management (01/15/2014) Goedert, Joseph

Amounts paid to individual physicians under Medicare will soon be released by the Centers for Medicare and Medicaid Services (CMS), but on a case-by-case basis. A district court ruling in May 2013 prompted the CMS to seek public comments last August on its policy of disclosing payment information. As a result, CMS will make case-by-case determinations of whether Exemption 6 of the Freedom of Information Act applies to a given request for information about the amounts paid to individual physicians under Medicare, according to a notice in the Federal Register. The exemption requires CMS to take into account the privacy interest of a physician as well as the public interest of disclosure.
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CMS Makes Dramatic Cuts to Breast Imaging
Dotmed (01/15/14) Dubinsky, Lauren

The Centers for Medicare and Medicaid Services (CMS) has released the final rule for the 2014 Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System. CMS will pay hospitals far less this year than last, and patients may have less access to breast cancer screening and diagnosis. CMS reduced the professional component of breast interventions 24 percent on average, and the technical component 17 percent. Stereotactic biopsy was reduced 45 percent for the professional component and 3 percent for the technical. The component coding system radiology uses to report its services forces a heterogeneous mix of services to be reported under a limited number of codes, which has resulted in these drastic cuts. All breast intervention codes were bundled into 14 new codes, which caused the cuts.
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EHR Payments Soar to Near $20B
Healthcare IT News (01/15/14) Brino, Anthony

Electronic health record (EHR) incentive payments for eligible doctors and hospitals have continued to rise in 2014. The "inexorable progress" of the federal EHR incentive program continues, with payments to providers moving increasingly close to $20 billion. At the end of November 2013, more than 436,000 hospitals and health professionals had registered for the Medicaid and Medicare EHR incentive program, and the federal government had made more than $17.7 billion in payments, according to the Centers for Medicare and Medicaid Services. Of the $17.7 billion paid, almost $11 billion has gone to 4,300-plus hospitals who have achieved meaningful use status, and $4 billion has gone to about 210,000 physicians and health professionals qualifying under Medicare and $2.5 billion has gone to 107,000 professionals.
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Some Rural Hospitals Face Cuts Under ACA
Canton Daily Ledger (01/11/14) Janney, Cristina

The Affordable Care Act (ACA) will result in an estimated $196 billion reduction in annual increases in Medicare payments to hospitals, skilled nursing facilities, and ambulatory surgical centers over the next decade. Hospital administrators say they will have to modify services and staffing to become more efficient and put more resources into primary care to curb unnecessary hospital admissions. Starting this year under the ACA, Medicare payments will be based on the quality of treatment patients receive. Hospitals will gain or lose 1 percent of Medicare funding based on 20 factors that measure quality of care specified on checklists.
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AHA: Uncompensated Care Fact Sheet
American Hospital Association (01/01/14)

Uncompensated costs at community hospitals totaled nearly $46 billion in 2012, up 11.7 percent from the previous year. The annual survey, which included about 5,000 hospitals, defines uncompensated costs as the estimated cost of bad debt and charity care to the hospital; this figure does not include Medicare or Medicaid underpayment costs. The $45.9 billion figure recorded in 2012 represents 6.1 percent of total hospital expenses.
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Survey Finds Few Orthopedic Surgeons Know the Costs of the Devices They Implant
Health Affairs (Winter 2014) Vol. 33, No. 1, P. 103 Okike, Kanu; O’Toole, Robert V.; Pollak, Andrew N.; et al.

Although physicians have been encouraged to factor in the cost when selecting implantable medical devices for orthopedic procedures, obtaining cost information can be difficult. A recent survey found that orthopedic attending physicians and residents were able to accurately estimate the cost of devices only 21 percent of the time. In addition, 36 percent of physicians rated their knowledge of device costs as "below average" or "poor." At the same time, more than 80 percent of the respondents said cost should be "moderate," "very," or "extremely" important in the device selection process. Ideally, the researchers said, surgeons should have greater access to information on the prices of devices and should be incentivized to take part in cost-containment efforts.
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