ASCA News Digest (June 10, 2014)

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June 10, 2014





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External Coding Audits: Maximize Their Value for Your ASC

Eliminate the drudgery often associated with conducting outside chart audits by learning how your ASC’s coding and billing staff can put your audit results to work to improve reimbursement and strengthen your ASC’s compliance plans. Learn more by registering for ASCA's next webinar on Tuesday, June 17, at 1:00 pm ET. ASCA members save $50. MORE
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Laser safety is an issue more ASCs need to address as the use of lasers grows and expands into various surgical specialties, including urology, ophthalmology, gynecology, ENT and podiatry. In addition, lasers are used frequently in many plastic surgery and dermatology procedures and in the treatment of small vascular anomalies and larger vascular pathologies. MORE
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Many experts have released studies or reports recently that conclude ASCs save billions while maintaining high-quality surgical care. ASCA’s Advancing Surgical Care web site now features a “What the Experts Are Saying” webpage that aggregates all of these findings in one location. MORE
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If you attended ASCA 2014 in Nashville, you have until June 30, 2014, to submit your continuing education credits online. To submit online, you will need your ID number located on the back of your attendee badge. (If you no longer have your badge, you can request your ID number by sending an email to registration@ascassociation.org.) MORE
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Order the entire package of all of the ASCA 2014 session recordings on ASCA's Learning Center. If you could not make it to the meeting or if you were unable to sit in on every session that you wanted to attend, order session recordings to review all of the education content that the conference had to offer. MORE
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According to the memo, “If State Survey Agencies (SA) or Accrediting Organizations (AOs) identify any of the breaches of generally accepted infection control standards listed in this memorandum, they should refer those breaches to the appropriate State authorities for public health assessment and management.” MORE
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Industry News


Should Doctors Work for Hospitals?
The Atlantic (05/27/14) Gunderman, Richard

The number of doctors employed by hospitals went up 34 percent between 2000 and 2010, according to the American Hospital Association, and the number of physician searches that were performed by hospitals went from 11 percent in 2004 to 63 percent in 2013. A previous boom in the 1990s found that doctors who move to hospitals often have lower productivity and morale.
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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.



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!



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Payne Requests President Obama Correct Unfair Medicare Policy for Polyp Removal During Life-Saving Cancer Screenings
InsuranceNewsNet.com (06/01/14)

Several members of Congress, including Rep. Donald Payne Jr. (D-N.J.) have sent a letter to President Obama requesting a change in Medicare coverage of polyp removal during a colonoscopy screening. The current health care law states that a private insurer cannot impose cost-sharing with respect to a polyp removal during a colonoscopy performed as a screening procedure. But Medicare beneficiaries are responsible for paying a coinsurance fee when a colorectal cancer screening colonoscopy also involves removing precancerous polyps. The lawmakers wrote that they "believe that this Medicare policy is counterproductive, inconsistent, and unfair to Medicare beneficiaries" and they have requested that the administration resolve this discrepancy.
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VHI Releases Outpatient Procedures Report Comparing Charges by Location
Virginia Health Information (06/02/2014)

A new report from Virginia Health Information (VHI) shows the increasing importance of outpatient surgery in medical care. VHI's "2012 Outpatient Procedure" reports provide consumers with information on such procedures as breast surgery, colonoscopy, facial surgery, gall bladder removal, general laparoscopic procedures, hernia repair, hysterectomy, knee surgery, and liposuction. VHI's Web site reveals that some surgeries like colonoscopy are performed in physician offices, ASCs, and hospital outpatient departments, while hernia repair is performed mainly in hospital outpatient departments and ASCs. "If you need to have an outpatient surgical procedure, talk with your doctor about the best place for your care, taking into consideration your specific needs and health," advises VHI's executive director Michael Lundberg.
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Green Mountain Care Board Skirts Key Issues in Public Health-Care Forum
Vermont Watchdog (05/30/2014) Parker, Bruce

The board of Green Mountain Care, Vermont's new health care system, conducted a "traveling board meeting" on May 29 in Burlington. Amy Cooper, an advocate for independent physician practices, asked whether the board had considered urgent care centers and ambulatory surgery centers. "One strategy that has worked elsewhere--and I don't see us employing here--is introducing lower-cost settings of care into the system. ... Urgent care centers and ambulatory surgery centers have reimbursement profiles and costs that, according to national studies, are much lower than performing these types of services in hospital-based settings," Cooper said. Michael Del Trecco, vice president of finance for the Vermont Association of Hospitals and Health Systems, said underpaying occurs frequently with governmental payers, placing a strain on other members of the health care system. He said Medicaid's payment shortfall totals $153 million annually and that shortfall gets shifted from non-payers to commercial payers.
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Cost-Effectiveness Analysis of Stocking Dantrolene in Ambulatory Surgery Centers for the Treatment of Malignant Hyperthermia
Anesthesiology (06/14) Vol. 120, No. 6, P. 1333 Aderibigbe, Taiwo; Lang, Barbara H.; Rosenberg, Henry; et al.

Dantrolene is, at present, the only treatment for malignant hyperthermia (MH), a rare hypermetabolic syndrome of the skeletal muscle and potentially fatal complication of general anesthesia. The Malignant Hyperthermia Association of the United States recommends that 36 vials of dantrolene (20 mg per vial) remain in stock at every ambulatory surgery center (ASC). To assess the cost-effectiveness of doing so, researchers used a decision-tree model to compare treatment with dantrolene to a supportive care-only strategy. Researchers estimated that 47 MH events occur annually in U.S. ASCs and that the incremental cost-effectiveness ratio was $196,320 in 2010 dollars per life saved compared with a supportive care strategy. The researchers found that the Malignant Hyperthermia Association's recommendation for stocking dantrolene is cost-effective when compared with U.S. regulatory agencies' estimated values of statistical life.
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Successful Results From CMS ICD-10 Acknowledgement Testing Week
Centers for Medicare & Medicaid Services (06/02/14) Brennan, Niall

The Centers for Medicare & Medicaid Services (CMS) conducted a successful ICD-10 testing week in March, during which testers submitted more than 127,000 claims with ICD-10 codes to the Medicare Fee-for-service (FFS) claims systems. Testers included large and small physician practices, small and large hospitals, labs, ambulatory surgical centers, dialysis facilities, home health providers, and ambulance providers. Nationwide, CMS accepted 89 percent of the test claims, with some regions reporting acceptance rates as high as 99 percent. The testers in many cases intentionally included errors to ensure claims would be rejected, a process known as negative testing. Providers, suppliers, billing companies, and clearinghouses can submit acknowledgement test claims any time up to the anticipated Oct. 1, 2015, implementation date.
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HHS Releases New Data and Tools to Increase Transparency on Hospital Utilization and Other Trends
HHS News Release (06/02/14)

The U.S. Department of Health and Human Services (HHS) has issued its first annual update to the Medicare hospital charge data, which compares the average amount that a hospital charges for services that may be provided during a similar inpatient stay or outpatient visit. The data, released at HHS' annual Health Datapalooza conference in Washington, D.C., now includes inpatient and outpatient hospital charge data for 2012. This information includes the average charges for services that might be provided in association with the 100 most common Medicare inpatient stays at some 3,000 hospitals across the country. In addition to the charge data, HHS released new interactive dashboards for the CMS Chronic Conditions Data Warehouse and geographic variation data, while the U.S. Food and Drug Administration unveiled OpenFDA, which is designed to facilitate easier access to large, important public health datasets collected by the agency.
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National Time Out Day: June 11, 2014
Association of periOperative Registered Nurses (06/05/14)

National Time Out Day, scheduled this year for June 11, is part of an annual awareness campaign launched by the Association of periOperative Registered Nurses. The designation of National Time Out Day is intended to support surgical nurses' ability to speak up for safe practices in the operating room. Now in its 10th year, National Time Out Day is support by The Joint Commission, the World Health Organization, and the Council on Surgical and Perioperative Safety for its efforts to boost awareness of safe practices that lead to optimal outcomes for surgical patients.
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ICD-10, Stage 2 Meaningful Use Will Challenge New HHS Leader
EHR Intelligence (06/06/2014) Bresnick, Jennifer

Newly confirmed Department of Health and Human Services (HHS) Chairman Sylvia Mathews Burwell is facing several major challenges, including the stalled ICD-10 transition and the scrambling to readjust timelines and materials which were previously firmly set in stone. Burwell will need to take the reins of a frustrated and transition-weary industry in the middle of a waiting game. She will also have to address the daunting process of guiding more providers towards the second stage of the EHR Incentive Programs. Burwell placed a strong focus on embracing data-driven healthcare during her genial confirmation hearings, flagging analytics and organizational coordination as the key to true efficiency.
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Regent Surgical Health Opens Physician/Hospital ASC Joint Venture With Portland Physicians, Providence Health & Services
PR Newswire (05/30/14)

Regent Surgical Health has opened the Plaza Ambulatory Surgery Center (ASC), a joint venture between Regent, local physicians, and Providence Health & Services in Portland, Ore. "Plaza ASC is the latest implementation of the classic Regent physician/hospital surgery center joint venture model, which is an ASC ownership structure that has proven to promote excellent patient care and successful, lasting businesses," says Tom Mallon, CEO of Regent Surgical Health. "We create ASCs that leverage the strengths of each party involved in the joint venture, and provide both physicians and their hospital partner significant equity." Regent has a minority stake in the new ASC, and it will also manage its operations. "This surgery center provides an outpatient venue to serve our patients at a lower cost and in a more convenient setting," says Dr. Justin Rufener, Plaza ASC board president.
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Surge Reported in Sales of Healthcare Plans
The Hill (06/02/14) Al-Faruque, Ferdous

A new report by the Kaiser Family Foundation indicates that 3 million to 3.5 million people enrolled in health coverage outside the ObamaCare exchanges in March, signing up through insurance companies or brokers. The report shows that 15 million people have obtained individual insurance through the private market. However, the foundation's estimates cover just two-thirds of the nation's insurers and do not include people who enrolled in April and May, but it expects that enrollment continued to rise during the last two months.
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Hospital Charges Surge for Common Ailments, Data Shows
New York Times (06/03/14) P. B1 Creswell, Julie; Fink, Sheri; Cohen, Sarah

Data for 3,317 hospitals released by Medicare officials on June 2 indicate that charges for most common inpatient procedures rose in 2012 from the previous year, and some increases were more than four times the national rate of inflation. The report shows that hospitals charged more for 98 common ailments in 2012, and the increases exceeded the 2 percent inflation rate for that year for all but seven of these ailments. Experts believe the increases could be offsetting higher technology or drug costs. The report also shows that the number of Medicare patients discharged from hospitals for these common ailments fell from 7.5 million in 2011 to 7.2 million in 2012, and the amount Medicare paid for their care dropped from $62.8 billion to $61.9 billion.
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