ASCA News Digest (May 13, 2014)

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May 13, 2014





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ASCA Highlights


Important Information for ASCA 2014 Attendees

Learn how to retrieve your badge and conference materials; information on substitutions, cancellations and badge changes; available continuing education credits; how to download the ASCA 2014 Program Guide; and transportation information from the airport. There is also information on appropriate dress, the expected weather in Nashville, Wi-Fi availability, the ASCA 2014 mobile app and what we're offering at the ASCA Booth in the Exhibit Hall. MORE
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Even though online registration for ASCA 2014 has closed, there will still be room for you in Nashville next week; simply register on-site. On-site registration, located outside the Exhibit Hall of the Gaylord Convention Center, will be open 7:00am–7:00pm on Wednesday, 7:00am–6:30pm on Thursday, 7:00am–5:00pm on Friday and 7:30am–12:00pm on Saturday. MORE
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Already registered for the annual meeting? The ASCA 2014 Community on ASCA Connect is a great place to network with other attendees and submit questions to the speakers. Let people know you are attending and help promote the conference using the hashtag #ASCACONF on social media sites such as Twitter, Facebook and LinkedIn. MORE
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ASCA's 5K Fun Run/Walk, during ASCA 2014 in Nashville, is a terrific way to get your body moving and energized for the rest of the day on Friday, May 16. Regular runners and first-timers alike are welcome to join us for the race, sponsored by SourceMedical. Registration starts at 6:15am and the race begins at 6:45am. All participants, whether running 3.1 miles or walking the 1 mile course, will receive a free pedometer and t-shirt. MORE
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CMS has removed the provision in the Conditions for Coverage requiring ASCs to have a radiologist on their medical staff. ASCA has long advocated for this change noting that requiring ASCs to have a radiologist on staff does not make sense given that radiologic services in an ASC are generally limited to intra-operative guidance that does not require interpretation by a radiologist. MORE
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A study published this week in Health Affairs finds that ASCs save money and increase efficiency for Medicare, insurers and patients alike, while providing the same high quality care as HOPDs. The study, conducted by health economists Elizabeth Munnich of the University of Louisville and Stephen Parente of the University of Minnesota, concludes that “ASCs are a high-quality, lower-cost substitute for hospitals as venues for outpatient surgery.” MORE
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US Department of Health and Human Services (HHS) Secretary Kathleen Sebelius resigned as the head of the agency last month and President Obama nominated Sylvia Mathews Burwell, who currently serves as director of the Office of Management and Budget (OMB), as her replacement. MORE
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Industry News


ASCs Continue to Move Into the Mainstream
Review of Ophthalmology (05/14) Stephenson, Michelle

Several factors are helping ASCs become a preferred alternative to hospitals for patients, surgeons, and payers. Stephen C. Sheppard, managing principal of Medical Consulting Group in Springfield, Mo., notes that 10,000 Baby Boomers are being added to the nation's Medicare rolls per day, and that this rate will likely continue for the next 15 years. "We are going to have to become more cost-effective, and ASCs are the low-cost providers of surgical services," he says. Sheppard adds that ASCs are efficient because nurses, technicians, and surgeons work as a team and become skilled in anticipating the next moves. Attorney Mark E. Kropiewnicki says some ophthalmologists are opting to become ASC owners, usually of single-specialty or multispecialty ASCs that already have several owners. Sheppard anticipates that hospitals will increasingly partner with ASCs in the future, leading to a relationship that benefits both parties.
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Procedures Take Less Time at Ambulatory Surgery Centers, Keeping Costs Down and Ability to Meet Demand Up
Health Affairs (Spring 2014) Vol. 33, No. 5, P. 764 Munnich, Elizabeth L.; Parente, Stephen T.

The volume of outpatient procedures nationwide has risen significantly since 1981, and today most surgeries take place in outpatient settings. Ambulatory surgery centers (ASCs) provide a lower-cost alternative to hospitals as channels for outpatient procedures. Surgeries performed in ASCs on average take 31.8 fewer minutes than those performed in hospitals, reflecting a 25 percent difference based on mean procedure time. Researchers believe ASCs will provide an efficient way to fulfill projected growth in demand for outpatient surgeries while curbing costs and enhancing the quality of health care delivery as mandated by the Affordable Care Act.
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New HHS Data Show Quality Improvements Saved 15,000 Lives and $4 Billion in Health Spending
U.S. Department of Health and Human Services (05/07/14)

The Department of Health and Human Services is reporting an overall 9 percent decrease in hospital-acquired conditions nationally during 2011 and 2012, based on preliminary data. After holding steady at 19 percent from 2007 to 2011 and decreasing to 18.5 percent in 2012, the Medicare all-cause 30-day readmission rate further declined to roughly 17.5 percent in 2013. This represents an 8 percent reduction in hospital readmissions among Medicare beneficiaries. The data indicates that hospitals and providers nationwide are achieving reductions in hospital-induced harm among patients as a result of robust public-private partnerships and implementing best practices.
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IT Experts Push Translator Systems to Convert Doc-Speak Into ICD-10 Codes
Modern Healthcare (05/03/14) Conn, Joseph

Some IT experts are recommending that doctors' practices use language-to-code translators to help ease the transition to ICD-10. These translators are integrated into electronic health records systems, and are designed to show clinicians easy-to-understand descriptions of patient complaints, diagnoses, and procedures in either English or Latin when they perform tasks such as preparing or updating problem lists. After the clinician selects one of these words or phrases, the translator displays the appropriate code in ICD-10 or some other type of code set. IT experts say these translators could make it easier to find the necessary ICD-10 codes, which in turn could help minimize the disruption to physician workflows and cash flows that could result from the transition to ICD-10.
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CMS Cancels ICD-10 Testing Slated for July
Health Data Management (05/02/2014) Slabodkin, Greg

ICD-10 testing for providers expected to take place in late July has been cancelled by the Centers for Medicare and Medicaid Services (CMS). "The July testing has been canceled due to the ICD-10 implementation delay. Additional opportunities for end-to-end testing will be available in 2015," a CMS statement issued May 2 said. Industry groups had earlier urged CMS to conduct external testing for providers, prompting the CMS in February to offer it for selected providers.
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Nationwide Use and Outcomes of Ambulatory Surgery in Morbidly Obese Patients in the United States
Journal of Clinical Anesthesia (05/06/2014) Rosero, Eric B.; Joshi, Girish P.

A very low percentage of ambulatory surgery involves people who are morbidly obese, according to new research. The study, which used data from the 2006 National Survey of Ambulatory Surgery, examined perioperative outcomes in morbidly obese and nonobese patients undergoing ambulatory surgery in the United States. Just 0.32 percent of the ambulatory procedures were performed on morbidly obese patients, who were significantly younger but had a higher burden of comorbidities than nonobese patients. Obese patients were more likely to undergo the procedure in hospital-based outpatient departments and had significantly shorter procedures than those who were not obese. The findings, the researchers suggest, indicate "a conservative patient selection."
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MOC Enrollment Increases With New Physician Requirements
Medical Economics (05/09/14) Marbury, Donna

A petition against new Maintenance of Certification (MOC) rules has been signed by nearly 15,000 physicians who say the requirements are unreasonable, costly, and excessively complex. However, the American Board of Internal Medicine (ABIM) says MOC enrollment is growing. Physicians were required by ABIM to comply with more frequent training and testing by May 1, or be publicly cited as not meeting MOC requirements. ABIM President and CEO Richard J. Baron says his organization has acknowledged the feedback but is also "gratified that patients, hospitals, medical groups, and others see enough value in the credential to rely on it as a marker for knowing that physicians are keeping up."
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So Much for Stop, Drop and Roll: CMS Proposes New Fire Safety Update
Lexology (05/01/14) Robert M. Wolin and ; Patel, Kinal

The Centers for Medicare & Medicaid Services (CMS) has proposed rules to revise Medicare/Medicaid fire safety standards that include adopting the National Fire Protection Association's 2012 edition of the Life Safety Code (LSC) and the Health Care Facilities Code (HCFC). The HCFC contains provisions pertaining to health care and ambulatory care facilities, while the LSC addresses fire safety requirements based on state building codes and accreditation standards for Medicare- and Medicaid-participating facilities. CMS also has redefined "health care occupancy" to eliminate exceptions for small facilities. If approved, the proposed rules could take effect after April 2015. They would apply to ambulatory surgery centers, hospitals, critical access hospitals, and long-term care facilities.
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Outpatient Endocrine Surgery Doesn't Raise Readmission Risk
Medscape (04/30/14) Tucker, Miriam E.

A pair of studies indicate that endocrine surgery performed in an outpatient setting does not raise the risk for 30-day hospital readmission. Researchers used data from the American College of Surgeons National Surgical Quality Improvement Program to identify risk factors linked to readmission following thyroid, parathyroid, and other endocrinal surgeries, including American Society of Anesthesiologists class of greater than 2 and renal insufficiency. Both studies also found that stays of less than 24 hours were associated with lower readmission rates than inpatient surgery. The findings were presented at the American Association of Endocrine Surgeons 2014 Annual Meeting in Boston.
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Doctors, Hospitals and Insurers Team Up
Orange County Register (CA) (05/01/14) Wolfson, Bernard J.

An accountable care organization (ACO) launched in 2012 comprising the St. Joseph Health System in Orange, Calif., and Blue Shield of California is seeing its efforts pay off. Internal data from the insurance company suggests that in its first year, the ACO achieved a significant reduction in patient admissions, length of hospital stays, emergency room visits, outpatient surgeries, and readmissions, resulting in savings of $11.5 million. Christy Mokrohisky, who supervises St. Joseph's performance improvement efforts, is now focusing on ways to keep chronically ill patients out of the hospital and away from the emergency room, such as by allowing pharmacists to go to clinics and doctor's offices to manage the prescriptions of sick patients.
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Weekly Emails to Hospital C-Suite Halt Two Decades of Superbug Outbreak
Association for Professionals in Infection Control and Epidemiology (04/28/2014)

Steps taken by a large Florida hospital to curb the spread of infections by carbapenem-resistant Acinetobacter baumannii proved ineffective until leaders started receiving weekly emails from the hospital's medical director of Infection Control, according to a new study in the American Journal of Infection Control. After the hospital started sending comprehensive weekly reports to physician, hospital nursing, medical, and administrative leaders, the rate of A. baumannii transmission decreased by 63 percent, says the research team from the University of Miami Miller School of Medicine. "These weekly emails not only packaged information on the number and locations of new acquisitions of A. baumannii, but also described and explained the results of environmental initiatives, hand culture results, and identification of shared objects among patients," the study authors wrote. "Additionally, these communications advised the hospital and each ICU's leaders about the infection control data and provided action plans based on the findings."
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Blog: Report: Federal Exchange a Comparative Bargain
Kaiser Health News (05/08/14) Rovner, Julie

A new report by Jay Angoff, former Missouri Insurance Commissioner and former director of the U.S. Department of Health and Human Services office tasked with implementing the health exchange program, says it cost an average of $647 to sign up each enrollee through Healthcare.gov, versus an average cost of $1,503 per enrollee for the 15 exchanges run by individual states and the District of Columbia. California was the only state-run exchange with an average per person cost under $1,000, but despite being the most efficient state-run exchange, it still cost $758 to sign up each enrollee. The costs were significantly higher in Hawaii ($23,899 per enrollee) and Washington, D.C. ($12,467 per enrollee). States in the federal exchange that were among the most resistant to the Affordable Care Act had the lowest per-person costs: $76 in Florida, $102 in Texas, and $427 in Michigan.
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