ASCA News Digest (March 11, 2014)

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March 11, 2014





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ASCA Highlights


Don't Lose Access to Your 2013 ASCA Benchmarking Reports

Participants in the 2013 ASCA Benchmarking Survey must subscribe to the 2014 survey to avoid losing access to their 2013 reports. Data collection for the first quarter (Q1) of the 2014 survey will open on April 1. Subscribe today. MORE
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Learn how to conduct a QAPI project that will lead to meaningful and sustainable improvements in your ASC. Register for ASCA's next webinar and find out which areas of your ASC you should study, how to identify, report and measure the data you need and how to implement change that produces lasting benefits for your patients, physicians and staff. MORE
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Learn what quality measures Medicare currently requires ASCs to report and get the definitions, instructions and answers to frequently asked questions about individual indicators that you need to ensure your ASC’s reporting success. Attend ASCA 2014 to find out what’s new in the quality reporting program in 2014 and what to expect in the future. MORE
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Recent changes to the HIPAA Privacy and Security Rules dramatically increase the potential liability for HIPAA violations for health care providers and their business associates. If an individual believes his or her protected health information (PHI) has been breached, the recourse is to file a complaint with the federal Office for Civil Rights (OCR). MORE
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As of March 31, only ASCA members who have renewed their membership for 2014 will continue to receive member benefits, including ASCA's Medicare Rate Calculator, the weekly Government Affairs Update and discounts on ASCA meetings, webinars and educational resources. If your center’s membership is not renewed as of March 31, you will lose access to these important benefits. MORE
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This year at ASCA’s annual meeting, we are celebrating the 40th anniversary of the association. We would like to invite all former ASCA board members to join us in Nashville for ASCA 2014, May 14–17 and be recognized. ASCA will waive the meeting registration fee for those who are no longer active in the ASC industry. MORE
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Sign up for QualityNet announcements about the ASC Quality Reporting Program today, including the ASC Quality Reporting Program Newsletter and updates to the Specifications Manual. Click here to select program notifications for “Ambulatory Surgical Centers.” MORE
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As the October 1, 2014, ICD-10 compliance date approaches, CMS continues to work in collaboration with providers and other industry stakeholders to help prepare for the transition. CMS is hosting a webinar this Thursday, March 13, at noon. The presentation will review ICD-10 basics, key preparation steps for a successful transition, billing and clinical documentation concepts. MORE
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US Senators Sherrod Brown (D-OH) and Rand Paul (R-KY) sent letters to CMS last week questioning the appropriateness of ASC Quality Reporting Program measure ASC-11 and asked CMS to reevaluate its application in the ASC setting. Sen. Paul asked that the measure be withdrawn for further examination and testing. MORE
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Your ASC, your patients and the future of ambulatory surgery in the US all rely on high-level policy decisions being made in Washington, DC, and your state capital each day. ASCA members receive a weekly Government Affairs Update with all the latest news affecting the ASC community and important information about how you and your ASC can get involved. Join ASCA to read more and to start receiving the Government Affairs Update every week. MORE
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Industry News


Is There a Doctor in the House? Yes, 17. And 3 in the Senate
New York Times (03/08/14) P. A1 Peters, Jeremy W.

An increasing number of physicians are seeking to enter public service by becoming lawmakers. Dozens of physicians are running for the House, some for re-election, and there are currently 20 people with medical degrees serving in Congress--17 in the House and three in the Senate. U.S. Senate candidates this year include an obstetrician in North Carolina, a radiologist in Kansas, and a liver disease specialist in Louisiana. Sen. Tom Coburn (R-Okla.), who had a family medical practice prior to becoming a lawmaker, says doctors today are facing responsibilities that shift them away from patient care, which needs to be reversed. Rep. Andy Harris (R-Md.), an anesthesiologist, says physicians do not like the notion of lawmakers without medical backgrounds making decisions that could affect the profession.
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National Colorectal Cancer Awareness Month
HHS News Release (03/05/14) Koh, Howard K.

March has been designated as National Colorectal Cancer Awareness Month. Colorectal cancer is the second leading cancer killer of men and women in the United States, but if detected early, illness and death can be prevented, according to U.S. Assistant Secretary for Health Howard K. Koh. The U.S. Preventive Services Task Force recommends that individuals between the ages of 50 to 75 be screened for colorectal cancer as part of routine preventive health care. The implementation of the Affordable Care Act now enables many Americans to receive preventive services, such as screening for colorectal cancer, with no patient cost-sharing. There are three tests, said Koh, that are effective at finding the cancer early: colonoscopy, highly sensitive stool tests (fecal occult blood test or fecal immunochemical test), and flexible sigmoidoscopy. Koh called for "greater national efforts to inform and remind appropriate patients that they are due for colorectal cancer screening, and ensure that all Americans between the ages of 50 and 75 receive this important life-saving intervention."
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Colon Cancer Awareness
WMBC-TV (03/07/14)

Gastroenterologists in New Jersey are calling attention to colon cancer this month in an effort to get more people screened for the second-leading cause of cancer-related deaths in the United States. One out of three people get polyps in their lifetime, according to Dr. Robert R. Levine of Bergen County Gastroenterology, but he adds, as long as they can control the polyps, they can control colon cancer. Dr. Anna Korkis of Gastroenterology & Liver Disease Internal Disease notes that contrary to popular belief, colon cancer can occur in women as well as men. "Women are just as much at risk as men are," she says. New Jersey ranks 29th nationwide in terms of colon cancer screening, with less than 60 percent of its residents being screened annually.
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Ambulatory Surgical Facilities in Northeast Pennsylvania Collaborate With the Pennsylvania Patient Safety Authority
Pennsylvania Patient Safety Authority (03/06/2014)

Ambulatory surgical facilities (ASFs) may be able to reduce day-of-surgery (DOS) cancellations by implementing protocols that include nurse-driven preoperative screening, a standardized checklist, and a second preoperative phone call to patients. The Pennsylvania Patient Safety Authority collaborated with 11 ASFs in the northeast region of Pennsylvania to implement new protocols. The partnership focused on DOS cancellations because they can lead to mix-ups with patient data, procedures, or medications. Following the adoption of the new protocols, DOS cancellations related to transportation and protocol fell by 28.5 percent and 22.4 percent, respectively, in patients who received a preoperative screening and assessment with a standardized checklist. The ASFs achieved a 9.7 percent reduction in their DOS cancellation rate.
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Obama Gives Health Plans Added Two-Year Reprieve
Wall Street Journal (03/06/14) Radnofsky, Louise

The Obama Administration announced that insurers can continue selling health plans until 2016 in some cases that do not comply with the Affordable Care Act. This follows the recent delay until 2016 in the requirement that employers provide coverage or pay a fee. However, requirements that insurers cover people with pre-existing conditions, offer more robust plans that cover preventive services with no out-of-pocket costs, and cover young adults on their parents' plans until age 26 have already been implemented. Moreover, low-income individuals now have access to tax credits to help pay their premiums.
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New Health Insurance Marketplaces Signing Up Few Uninsured Americans, Two Surveys Find
Washington Post (03/06/14) Goldstein, Amy; Millman, Jason

New surveys indicate that the health insurance marketplaces have not signed up large numbers of uninsured. A survey by McKinsey & Co. shows that just one in 10 uninsured individuals who qualify for private exchange plans had enrolled as of February, and of the uninsured who do not plan to enroll, most believe they cannot afford the coverage. Meanwhile, another survey by the Urban Institute reveals that only half of uninsured adults have looked or plan to look for information on the online exchanges. Although awareness of the new marketplaces is widespread, the survey found that uninsured and low-income individuals are less likely to know about them.
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HHS Seeks $600 Million for Health Law Enrollment Efforts
Kaiser Health News (03/05/14) Carey, Mary Agnes

The U.S. Department of Health and Human Services (HHS) says even if Congress does not pass President Barack Obama's fiscal 2015 budget plan, the agency will be able to obtain the funds needed to implement the federal health law. The Affordable Care Act is predicted to generate $1.2 billion in user fees, including those on health insurers who take part in its online marketplaces. The administration's proposed budget plan allocates an extra $600 million to run the federal marketplace, call centers, and outreach initiatives, according to Ellen Murray, assistant HHS secretary for financial resources. If Congress does not endorse the budget, the HHS secretary's office has the authority to transfer funds from existing accounts or access the federal non-recurring expense fund.
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Pediatric Surgeons and Anesthesiologists Develop Standards for Optimal Resources for Children's Surgical Care in the United States
Journal of the American College of Surgeons (03/14)

The Task Force for Children's Surgical Care has developed new guidelines that surgical centers should follow to ensure the safely of infants and children. For instance, both Level II and III surgical centers must be able to stabilize and transfer critically ill children to a hospital with higher-level resources, and all children's surgical centers must have at least one pediatric surgical nurse, pediatric rapid response team, and in-house physician with Pediatric Advanced Life Support certification or equivalent qualifications. Additional guidelines for ambulatory, or outpatient, surgical centers include having preoperative and recovery areas dedicated to pediatric patients. The task force report also states that pediatric anesthesia providers at ambulatory surgical centers should administer or supervise the administration of a general anesthetic or sedative to all infants below the age of one year. Plans are now underway to develop criteria for evaluating existing facilities that perform children's surgical procedures, said task force chair Keith T. Oldham.
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Redesigning Hospital Alarms for Patient Safety
Journal of the American Medical Association (03/03/14) Chopra, Vineet; McMahon Jr., Laurence F.

Alarm failure and alarm fatigue can be problematic for hospitals, but there are three steps that can help make them safer. An opinion piece in the Journal of the American Medical Association suggests creating an "alarm priority," such as getting rid of "any audible or visual alert that does not signify a clear or potential risk ... in the context of its implementation"; reconfiguring alarms to the workflow; and integrating alarms so they work together. The authors note, for example, that "a low blood pressure alarm means little in isolation to a clinician. If, however, the blood pressure reading is also accompanied by a rapid heart rate and knowledge that these trends represent deviations from baseline, a meaningful message is created."
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Status of the Implementation of the World Health Organization Multimodal Hand Hygiene Strategy in United States of America Health Care Facilities
American Journal of Infection Control (03/01/2014) Vol. 42, No. 3, P. 224 Allegranzi, Benedetta ; Conway, Laurie; Larson, Elaine; et al.

U.S. health care facilities that took part in a World Health Organization (WHO) hand hygiene survey showed encouraging progress in improving their institutional safety climate. The study--which used the Hand Hygiene Self-Assessment Framework, a validated tool based on the WHO's Multimodal Hand Hygiene Improvement Strategy--suggests that facilities should have appropriate infection preventionist staffing levels and that hand hygiene efforts need to be incorporated into a stronger institutional safety climate. The use of posters or other reminders detailing hand hygiene indications and performance techniques can likely enhance best practices at the point of care. According to the authors, "These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign."
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Bundled Payments Give Surgeons a Powerful New Incentive to Reduce Costs
Modern Healthcare (03/01/14) Lee, Jaimy

Hundreds of hospitals across the country are participating in bundled-payment arrangements offered by Medicare and a number of private payers in order to improve the quality of the health care they provide and to maximize profits from surgeries and other forms of care. Such arrangements establish a set price for an episode of care that includes the cost of any implant or device used as well as the surgeon's costs and fees and the cost of the facility and anesthesiologist. Since hospitals and doctors split any profit they make from bundled-payment arrangements, they generally do a better job of working together to keep the costs of care down. This can include asking implant and device makers to give them the best prices for their products, as well as efforts to reduce readmissions, unnecessary imaging and lab tests, and average length of stay. However, there are a number of obstacles to the success of bundled-payment arrangements, including doctors' preferences for certain devices or device manufacturers.
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SullivanCotter's Physician Compensation Survey Reveals Decreasing Gap Between Primary Care and Specialty Physician Compensation
Sullivan, Cotter and Associates, Inc. (02/25/2014)

Data from Sullivan, Cotter and Associates, Inc. reveals an overall increase of median total cash compensation of 5.7 percent for primary care physicians between 2012 and 2013, while medical and surgical specialists saw an increase of 3.2 percent and 2.3 percent, respectively. The report also found that the overall median amount paid for quality as a performance-based metric in 2013 was $15,000, which varied from $7,000 median quality payments for primary care to $20,000 for medical and surgical specialties. When regarded as a portion of total cash compensation, the overall median amount paid for quality was 5.0 percent. The survey report contains data from 484 organizations covering more than 91,000 health care providers, including total cash compensation data on 230 physician, Ph.D., and advanced practice clinician specialties, as well as eight medical group executive positions.
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