ASCA News Digest (July 8, 2014)

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July 8, 2014





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ASCA Highlights


Gains Made in Medicare’s 2015 Proposed Payment Rule

CMS accommodated several important requests made by ASCA and the ASC community in its proposed ASC payment rule for 2015. First, CMS is proposing to add ten new spine procedures to the ASC list of payable procedures for 2015. CMS is also proposing more favorable terms for device-intensive procedures and to make ASC-11 a voluntary measure in the ASC Quality Reporting Program. The proposal, however, continues to promote a growing gap between ASC and HOPD payments by setting the ASC payment update at 1.2% (based on the CPI-U) and the HOPD payment update by 2.1% (based on the hospital market basket). MORE
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CMS has released its July addenda, which provides third quarter updates to the ASC payment system. ASCA’s payment resources, including the Medicare Rate Calculator, have been updated to incorporate the July addenda changes. One notable change is that surgical code 0356T (Insrt drug device for iop) has been added to the ASC list of payable procedures effective July 1. MORE
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Planning has begun for ASCA 2015 in Orlando, May 13–16, 2015. Your ideas for session topics and speakers are an invaluable part of determining the exceptional educational content that the meeting will provide every year. Submissions for ASCA 2014 will be accepted through July 31, 2014. MORE
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Oregon Outpatient Surgery Center in Tigard, Oregon, kicked off its “Save Our Veterans” program yesterday. Learn more about that program and the many ways that ASCs are giving back to their communities and others around the world on ASCA’s new “ASCs Giving Back” web page. If your ASC is “giving back,” please send a short description of your program to editorial@ascassociation.org so that we can share your story on the “ASCs Giving Back” web page. MORE
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Informed consent in the ASC setting has different implications than the surgeon/patient informed consent. Explore the boundaries and responsibilities of ASC staff during ASCA's next webinar on Tuesday, July 22, at 1:00 pm ET. ASCA members save $50 on all of ASCA's webinars and can register for the entire 2014 series to receive an additional 10% off the total price. MORE
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Ensuring Patient Safety with Capnography
The RespSense™ and LifeSense® capnography monitors are simple-to-use, cost-effective tools that help you ensure your patients are adequately ventilated during sedated dental procedures. The monitors provide continuous and reliable monitoring to help identify potentially life-threatening ventilation status changes such as respiratory depression during dental procedures on sedated patients.



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.



Simplify your business office operations. Surgical Notes is a nationwide provider of transcription, coding, and document management applications. The ASC industry’s largest management companies and roughly 20,000 healthcare providers trust Surgical Notes to provide customer-focused solutions that eliminate manual processes, streamline workflow, and accelerate the revenue cycle. Visit us at www.surgicalnotes.com or call 800-459-5616 today!

Register now for ASCA’s 2014 Fall Seminar, which will take place October 9–11, 2014, at the Talking Stick Resort—a Four-Diamond resort in Scottsdale, Arizona. ASCA members enjoy a discounted registration fee and can save even more by registering before August 31. The 2014 Fall Seminar will offer educational sessions on key topics that drive development and daily operations at your ASC as well as the CASC Review Course and Exam. MORE
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Join hundreds of ASCs from around the country on Wednesday, August 13, and celebrate National ASC Day. ASCA can help you set up a tour of your center with an elected official. Tours are the best way to show the great work you do. For help participating in National ASC Day or setting up a tour, please contact Jack Coleman at jcoleman@ascassociation.org. MORE
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CMS posted another addendum to the ASC Quality Reporting (ASCQR) Specifications Manual. The most substantial change is that code V13.89 is being removed from measures ASC-9 and ASC-10 because it is non-specific for history for colonic polyps. MORE
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Industry News


Big Cyber Hack of Health Records Is 'Only a Matter of Time'
Politico (07/01/14) Pittman, David

The health care industry could soon see a major hack that exposes tens of thousands of patients' medical and financial records. Experts are not sure exactly when this could occur, but as medical data become increasingly digital, health records are an attractive target for hackers. A full identity profile from one record brings as much as $500 on the black market, but so far, lawmakers have been slow to act on cybersecurity legislation. The Identify Theft Resource Center identified 353 breaches in 2014, almost half of which occurred in the health sector. However, health care is the least prepared for a cyber attack, and it has some of the highest volume of threats and the slowest response time. Since 2009, more than 31.6 million Americans have had their medical records exposed through a hack, theft, or unauthorized disclosure.
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Colonoscopy Utilization and Outcomes 2000 to 2011
Gastrointestinal Endoscopy (07/14) Vol. 80, No. 1, P. 133 Lieberman, David A. ; Williams, J. Lucas; Holub, Jennifer L.; et al.

A recent study found that the use of colonoscopy as an average-risk screening tool nearly tripled between 2000 and 2011. Researchers looked at more than 1.37 million reports and found that the most common reason for colonoscopy in patients younger than 50 was for symptoms of irritable bowel syndrome and bleeding or anemia. Patients ages 50 to 74 most commonly received colorectal cancer screenings, while those over 74 years were most often screened for cancer or polyps. The researchers also noted that the prevalence of large polyps increases with age and is higher for men.
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Center For Sight Donates Over 20 Free Cataract Surgeries for Uninsured Manatee County Patients
Bradenton Times (06/21/14) Spinner, Miranda

A Sarasota, Fla., surgery center performed more than 20 free cataract surgeries in early June as part of Mission Cataract. The surgeries were donated by Center For Sight to uninsured patients with poor vision due to cataracts, mainly from Sarasota, Manatee, and Charlotte counties, though some patients came from out of state as well. "Participating in Mission Cataract each year renews our passion for the profession," said Dr. William L. Soscia of Center For Sight. "Once you've seen the impact these surgeries have on a person's life, there is no other option than to help ... and we are fortunate to be able to do just that." This is the center's 20th year of providing free cataract surgeries through Mission Cataract. In all, more than 100 surgeries were performed throughout the southeastern United States under the program.
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ICD-10 Delay: Organizations Prep for New Deadline
Informationweek HealthCare (06/30/14) Diana, Alison

Many health care providers are using the 12-month ICD-10 delay to prepare for the new deadline. A new survey of 349 health care organizations, vendors, and consultants conducted by eHealth Initiative and the American Health Information Management Association found that 61 percent of organizations are using the extra time to train additional staff, 60 percent are improving documentation integrity, 47 percent are continuing to dual-code, and 40 percent are conducting more robust testing. Forty percent of the respondents said they plan to start end-to-end testing by year-end 2014, while 25 percent expect to start by the end of 2015. Approximately 40 percent of the organizations that are not planning end-to-end testing said they did not know how to perform the testing. At a webinar to present the findings, panelists said that each ICD-10 delay has a number of effects, including waning executive buy-in as health care groups lose the sense of immediacy around ICD-10, students are concerned about their skills, and funds may get reallocated to other health IT initiatives.
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Hospitals Are Mining Patients' Credit Card Data to Predict Who Will Get Sick
Bloomberg Businessweek (07/03/14) Pettypiece, Shannon; Robertson, Jordan

Some health systems around the country are starting to use consumer data to identify high-risk patients who may need a lifestyle intervention from their doctors. Carolinas HealthCare System, which operates the largest group of medical centers in North and South Carolina, purchases data from brokers who cull public records, store-loyalty programs, and credit-card purchases. Michael Dulin, chief clinical officer for analytics and outcomes research at Carolinas HealthCare, says that such data can give a more complete picture of a patient. For example, the system may look at the probability of someone having a heart attack by considering factors such as food purchases or whether the patient has a gym membership. The health care system is not allowed to disclose specific details, such as transactions by an individual, but patients and advocates are still concerned that this use of data could threaten privacy and erode the doctor-patient relationship.
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Fremont Surgical Options Expand
Pueblo Chieftain (CO) (07/02/14) Harmon, Tracy

Residents of the Canon City area in Colorado will soon see more outpatient surgical options from a partnership between St. Thomas More Hospital and the Arkansas Valley Surgery Center. The partnership is expected to increase access to outpatient procedures in Fremont County and encourage partnership among the hospital, the surgery center, and their participating physicians. "It also will provide a convenient option for surgeries performed on an outpatient basis that do not require a hospital setting, such as ear, nose, and throat or orthopedic procedures,” said Jillian Maes, hospital spokeswoman.
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Truman Medical Centers Will Build Facility on Hospital Hill
Kansas City Star (06/25/14) Stafford, Diane

A groundbreaking ceremony has been scheduled for a $29 million Hospital Hill Outpatient Center in Kansas City, Mo., as part of the Truman Medical Centers system. The four-story, 90,000-square-foot facility is scheduled for completion by June 2015, and will feature oral, maxillofacial, orthopedic, and plastic surgeries, along with a diagnostic imaging center and additional services. The new structure will consolidate Hospital Hill's outpatient services, which served nearly 225,000 patients in 2013.
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Sign-Ups Not the Only Way to Gauge Health Law's Success
Wall Street Journal (07/05/14) McGinty, Jo Craven

While the 8 million enrollees under Obamacare are enough to consider the roll out of the health insurance marketplace a success, enrollment figures are just one measure that ultimately will determine how well the Affordable Care Act works; and it could take a year or more to gauge whether the law really has been successful. Observers note that to maintain enrollment projections, the number of enrollees must double next year. Moreover, more healthy people need to purchase coverage to offset the costs of insuring the sick, and premiums must remain low to retain existing enrollees and attract new ones. Premiums are expected to increase next year, but given that insurers are still paying claims and checking eligibility related to the most recent open enrollment period, observers say it remains a guessing game.
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Video Observation to Map Hand Contact and Bacterial Transmission in Operating Rooms
American Journal of Infection Control (07/01/2014) Vol. 42, No. 7, P. 698 Rowlands, John; Yeager, Mark P.; Beach, Michael; et al.

Researchers used intraoperative video observation to track patterns of anesthesia provider hand contact with anesthesia work environment (AWE) surfaces and to determine hand hygiene (HH) compliance. Serial bacterial cultures of high contact objects were used to characterize bacterial transmission over time. The researchers found a large number of HH opportunities and a low rate of HH compliance by anesthesia providers, with no correlation between frequency of hand contact with the AWE and bacterial contamination. According to the authors, while adherence to existing HH recommendations by anesthesia providers may not be feasible, "there does appear to be a correlation between HH compliance rates and bacterial contamination of the AWE, an observation that should stimulate further work to design new methods for control of bacterial transmission in operating rooms."
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New! AGA Introduces DHRP Modules for CRC Screening and Prevention
American Gastroenterological Association (06/19/14)

A new module for colorectal cancer (CRC) screening and prevention has been added to the American Gastroenterological Association's (AGA's) Digestive Health Recognition Program (DHRP). The DHRP can be used to report to the Centers for Medicare and Medicaid Services (CMS) Physician Quality Reporting System, help negotiate with payors, and gain American Board of Internal Medicine Maintenance of Certification points. The new AGA CRC Screening and Surveillance Registry is a CMS-approved qualified clinical data registry and was developed in collaboration with CECity.
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Local Surgeons Stitch Up New Collaboration
Walla Walla Union-Bulletin (WA) (06/18/14) Hagar, Sheila

A collaboration between two Walla Walla, Wash., medical providers will help integrate health care in the region, lower costs, and allow the organizations to better serve their respective patients. The deal allows the Walla Walla Clinic to bring two of Walla Walla General Hospital's surgeons to its outpatient surgery center. Beginning in August, Drs. Scott Newbold and Daryl Reid of Adventist Health will serve patients using the Walla Walla Clinic Ambulatory Surgery Center while continuing their hospital practices. Specialties planned for the rotation include orthopedic surgery and gastroenterology, with other specialties being considered.
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Physician Payments 50 Percent Higher in Milwaukee Than Across Midwest: Milliman
Milwaukee Business Journal (06/12/14) Kirchen, Rich

Commercial physician payment levels in southeast Wisconsin are almost 50 percent higher than the Midwest average payment rates, according to a new study from Milliman. This translates into a 15 percent higher cost in commercial health insurance premiums than the Midwest average physician payment levels. The Greater Milwaukee Business Foundation on Health says several factors are likely responsible for the higher payment rates, such as variances in operating costs, operational efficiency, physician productivity, payer mix and the related cost-shift burden to commercial payers, investments in care management, quality-improvement efforts, and physician income levels.
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