ASCA News Digest (July 29, 2014)

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July 29, 2014





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ASCA Highlights


Q2 of ASCA Benchmarking Closes on Thursday

The data collection period for the second quarter (Q2) of the 2014 ASCA Benchmarking Program closes on Thursday, July 31. If you haven’t purchased your 2014 subscription yet, there is still time to sign up. Even though you are subscribing during Q2, you will still receive the national/specialty report for Q1. Subscribe today and start submitting your data before Thursday. MORE
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Help us plan next year’s annual meeting. Submit your ideas for session topics and speakers so that we can provide you with the exceptional educational content that matters to you most. Submissions are due on Thursday, July 31. ASCA 2015 will take place in Orlando, May 13–16, 2015. MORE
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Learn about Medicare's proposed changes to ASC reimbursement rates for 2015, additions to the ASC-eligible list and changes to Medicare's quality reporting measures—and what you can still do to help shape the final rule—during ASCA's next webinar. "Understanding Medicare's Proposed Rates for 2015" on Tuesday, August 5, at 1:00 pm ET. MORE
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ASCA’s 2014 Fall Seminar in Scottsdale, Arizona, offers you an outstanding opportunity to tap into the expertise of some of the top experts in ASC management today as you explore practical solutions for making the most of new trends and best practices in your ASC. Because you register only for those days that best meet your needs, you can design an itinerary built to fit your budget and your travel schedule. MORE
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Medicare’s 2015 ASC payment proposal accommodates some important requests made by ASCA and the ASC community, but the disparity in payments between hospital outpatient departments (HOPDs) and ASCs continues to grow under the proposed rule. There are also some proposed changes that fall under the OPPS portion of the rule that could eventually impact ASCs. 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!

ASCA is conducting a brief survey to determine which procedures should be added to the list of ASC payable procedures for 2015. This information will help ASCA advocate for the expansion of the list of procedures that CMS considers clinically appropriate for ASCs to provide to Medicare beneficiaries. Participants must complete one survey for each procedure they would like added. MORE
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Mere mention of the word reports can cause much angst among health care professionals. In ASCs, as legislative and regulatory requirements continue to change and evolve, they are placing a hefty burden on staff. But reporting can streamline processes in some instances and save centers time and money. MORE
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Support Excellence in Your ASC
Register for ASCA’s 2014 Fall Seminar, October 9-11, in Scottsdale, AZ. Get innovative solutions and state-of-the-industry advice for improving clinical care, business office management, materials management and your ASC’s bottom line. Attend one, two or all three days of the seminar. Early registration discounts end August 31.



Earn Your Continuing Education Credits
Get the insider information and real-world solutions you need to navigate the regulatory and accreditation requirements, billing and coding changes and clinical and operational concerns you face in your ASC every day by signing up now for ASCA’s 2014 Webinar Series. ASCA members save $50 on each webinar.



Save the Date for ASCA 2015
Mark your calendar for next year’s annual meeting, May 13-16, 2015. ASCA 2015 will take place at the Orlando World Center Marriott Resort & Convention Center. The hotel, just five minutes from Disney World, boasts 10 restaurants/lounges, 18-hole championship golf, a rejuvenating spa and a dedicated children’s splash park.

Last week, in conjunction with the American Cancer Society's Cancer Action Network Fly-In, more than 500 letters were sent to members of Congress urging them to support the Removing Barriers to Colorectal Cancer Screening Act (H.R. 1070/S. 2348). Thank you to the hundreds who participated and for making it one of the most successful two-day pushes ever for ASCA. MORE
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Industry News


Location, Location, Location: Hospital Outpatient Prices Much Higher Than Community Settings for Identical Services
National Institute for Health Care Reform (06/26/2014) Reschovsky, James D.; White, Chapin

The prices for many common imaging, colonoscopy, and laboratory services in the average hospital outpatient department may be twice the price for identical services provided in a community-based setting such as a physician’s office, researchers at the former Center for Studying Health System Change have found. The study authors based their findings on the private insurance claims for about 590,000 active and retired non-elderly autoworkers and their dependents. The average price for an MRI of a knee was about $900 in hospital outpatient departments, but about $600 in physician offices or freestanding imaging centers. A basic colonoscopy cost $1,383 at an average hospital outpatient department, but $625 in community settings. Across 18 metropolitan areas, prices varied widely between the two types of sites for a variety of services. The price variation suggests that, besides the greater overhead costs and sicker patients of hospitals, there may be large differences in hospitals' bargaining ability relative to health plans that allow some hospitals to negotiate higher prices than others.
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All Eyes on Surgery Center, Symbion Integration in $792M Deal
Tampa Bay Business Journal (07/21/14) Manning, Margie

Tampa, Fla.-based Surgery Center Holdings' integration with Symbion Holdings will be closely monitored by both Standard & Poor's Ratings Service and Moody's Investors Service. The $792 million merger between Surgery Center, which runs 47 ambulatory surgery centers in 18 states, with Symbion, which operates 50 short-stay surgical facilities in 24 states, is expected to be completed in the fourth quarter of this year. S&P has given Surgery Center Holdings a stable outlook and a "B" rating, which reflects "the company's narrow operating focus in a fragmented and competitive market" as well as "some integration risk related to adding an acquisition of this size." Moody's, meanwhile, assigned the company a negative outlook in view of its debt and integration challenges; but it also affirmed its B3 corporate rating for Surgery Center Holdings, noting the long-term growth prospects of the ambulatory surgery industry.
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Docs Slam Recertification Rules They Call a Waste of Time
Kaiser Health News (07/21/14) Rabin, Roni Caryn

Time-consuming and expensive new board recertification rules for physicians could force some practitioners out of business, and they could make it difficult to bring physicians to more rural areas, according to specialists. While certification has always been voluntary, and until the 1980s most medical specialties granted certification for life, most of the 24 specialty boards eventually began requiring recertification every 7-10 years, and consumers are increasingly using credentials as a quality indicator. The standards became even more stringent earlier this year for some specialties with the shift to continuous maintenance of certification activities, and state licensing boards require continuing medical education credits on top of that. Supporters argue that the new process, which requires physicians of all ages to complete a long list of requirements every two or three years in order to maintain their certification, helps to ensure that doctors integrate the latest medical knowledge into their practices; but some critics say the process is a waste of time, particularly when the nation faces a shortage of physicians. To that end, more than 16,000 physicians have signed on online petition calling on medical specialty boards to eliminate the new rules, and some older physicians say they may just retire.
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Detour on the Road to ICD-10
Informationweek HealthCare (07/18/14) Graham, Deborah

Some organizations had made significant progress in their preparations for compliance with ICD-10, a modernization of the international standard for diagnosis codes, but Congress delayed Medicare's October 1 deadline by one year. In a commentary, Deborah Graham, a senior programmer/analyst at a large hospital system in Massachusetts, writes that her organization decided to halt all ICD-10 activity until there was a firmer date and the deadline was closer. It plans to resume ICD-10 testing about six months before the definite new date, but any hint that the date might change again will keep the organization from putting in as much effort as when it was aiming for an October 2014 compliance date. Instead, the hospital system is focusing on a major initiative called Patient Access, which seeks to make it easier for patients to contact providers and get an appointment faster. Graham's team is focused on patient self-scheduling and using their electronic medical record's (EMR's) existing patient portal by sending available appointment times to the EMR through the interface and letting enrolled patients book appointments with providers.
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Scaling Down the Hospital
Healthcare Finance News (07/24/2014) Andrews, John

Real estate experts say Medicare policy is encouraging shorter inpatient hospital stays and increased use of post-acute care, reducing the need for massive facilities. Tim Delgado of Read King Medical Development forecasts that "the future of new health care facility development will feature more retail-based facilities and 'community care clinics' that will house multiple programs, ranging from primary care, urgent and emergency care, physical therapy, imaging centers, outpatient surgery, and other programs that are under one roof with separate treatment areas." One result of the forced migration of patients outside of hospitals is the empowerment of physicians. "The pursuit and employment of physicians and physician groups will continue to grow," he predicts. "This shift to employment means that providers will need to add new facilities in the areas where these physicians practice."
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Ambulatory Surgery Center Gets OK
Greater Wilmington Business Journal (07/18/14) Little, Ken

The North Carolina Division of Health Service Regulation has approved Wilmington Health's request to expand its ambulatory surgery center in Wilmington. Wilmington Health CEO Jeff James said the expansion will allow multiple specialty surgical services "to now be performed within the facility," which will impact such areas as plastic surgery, podiatry, ENT, orthopedics, general surgery, and urology. "Changes to the health care delivery system, like greater utilization of ambulatory surgery centers, are a big step in reducing the cost of care for both the patient and the health care system," James said. "As an accountable care organization, we have a responsibility to reduce costs wherever possible. This new facility allows us to do just that."
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Rules Limit Patient Options
Rutland Herald (VT) (07/25/14) Mazur, Frank

The certificate of need regulatory process in Vermont keeps hospitals and health care providers from providing unapproved new services, writes Frank Mazur in a letter to the editor. While the aim is to lower costs by keeping providers from over-investing in facilities and equipment, a recent study from George Mason University's Mercatus Center found that the certificate of need decreases health services and raises costs, as it limits competition between providers and hospitals. In addition, the study found that states with certificates of need limit procedures such as MRIs, CT scans, and colonoscopies. The certificate of need, Mazur adds, also makes it more difficult for physicians "to open and operate ambulatory surgery centers and other facilities that would allow consumers potentially lower costs and higher quality."
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Safety Advocates Push to Curb Hospital Surgical Fires
Modern Healthcare (07/12/14) Carlson, Joe; Rice, Sabriya

The Food and Drug Administration (FDA) is taking a multi-pronged approach to addressing the problem of surgical fires, which can begin when electrosurgical tools ignite concentrated oxygen or alcohol-based antiseptics. The agency is working with 28 organizations to raise awareness about the issue, and it is trying to reduce the number of such fires, which occurred about 240 times a year between 2004 and 2011, according to the ECRI Institute. The FDA has already been promoting its Preventing Surgical Fires Initiative, which includes recommendations for the safe use of surgical equipment. In addition, hospitals--particularly those that have experienced surgical fires--have taken steps such as banning the use of alcohol-based antiseptics and ensuring that saline water is on hand during procedures where the risk of fire is high.
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Quality Reporting That Addresses Disparities in Health Care
Journal of the American Medical Association (07/16/14) Vol. 312, No. 3, P. 225 Jha, Ashish K.; Zaslavsky, Alan M.

Despite efforts to reduce the inequities in health care through policy changes, there is evidence that patient care disparities could increase, rather than decrease. For instance, Medicare's pay-for-performance initiative, the Hospital Readmissions Reduction Program, disproportionately penalizes safety-net hospitals that primarily care for disadvantaged and poor patients. This evidence has prompted greater discussion about adjusting quality-performance scores for the socioeconomic status of patient populations. Caring for these disadvantaged and low-income patients brings a number of challenges from nonclinical barriers, like less access to care, to fewer resources available for disease management.
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Doctors Aren't Grasping for Cost Transparency Tools
Managed Care (07/01/14) Kirkner, Richard Mark

Evidence suggests that some physicians may still be unaware of or uninterested in using cost transparency tools to inform their recommendations to patients of what medical services and procedures to use, despite an aggressive push by policymakers to boost such transparency. A recent report from the Gary and Mary West Health Policy Center estimates that greater cost transparency could lower health care spending by $100 billion over the next 10 years, but the center's Joseph Smith says supplying price information to physicians, employers, and policymakers may have a greater overall effect than providing it only to patients. Some experts note there is resistance in the medical community to bring up the subject of money with patients, but studies anticipating major increases in national health care costs over the next decade also see unnecessary hospitalizations as a driver of cost for critically ill patients. With little attention committed to cost sensitivity in medical training, the American College of Physicians' Steven Weinberger has proposed the addition of cost-consciousness and stewardship of care resources as a seventh general competency mandated by the governing bodies of medical education. In addition, health plans' ongoing refinement of their cost-containment tools is critical for securing physician buy-in.
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