ASCA News Digest (October 28, 2014)

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October 28, 2014





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ASCA Highlights


Add Your Industry Announcement to ASCA’s ‘Names in the News’ Webpage

Do you have a new hire? Did your ASC or company win an award? Or did your management change? You can highlight all of your important announcements on our new Names in the News webpage. This resource is available for free to both ASCA members and nonmembers. Please send your news to editorial@ascassociation.org. MORE
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Medicare’s Final ASC Payment Rule for 2015 is expected to be released soon. ASCA will send out an announcement with an instant analysis to all members as soon as it is released. Register now for ASCA’s next webinar, “Medicare’s Final Rates for 2015,” to get the final word on the changes to Medicare’s ASC payment system that will take effect January 1, 2015. The webinar will take place at 1:00 pm ET on Tuesday, November 18, 2014. MORE
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There is still time to purchase a subscription and submit your data for the third quarter (Q3) of the 2014 ASCA Benchmarking Program. The data collection period for Q3 closes on Friday, October 31. Even though you are subscribing during Q3, you will still receive the national/specialty reports for Q2 and Q1. MORE
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In the highly competitive ASC industry, surgery center owners and managers must continually look for new ways to improve operational efficiencies and increase revenue. With several economic issues affecting case volume and revenue growth, the task today is that much more complex. MORE
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Medicare-certified ASCs will be required to report 10 quality measures in 2015 for Medicare's ASC Quality Reporting Program. To help ASCs comply and avoid payment penalties down the line, ASCA has developed a free quality reporting resource that identifies the deadlines and reporting mechanisms associated with all 10 quality measures that ASCs will need to report next year. MORE
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Hospira announced it will initiate a voluntary recall of one lot of 1% Lidocaine HCI for Injection, USP, 10 mg per mL, 30 mL Single-dose, Preservative-Free due to a confirmed customer report of particulate in a single unit. Anyone with an existing inventory of the recalled lot should stop use and distribution and quarantine the product immediately. MORE
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The US Drug Enforcement Administration (DEA) issued a letter clarifying information provided in the final rule on the disposal of controlled substances released recently. Responding to confusion about the disposal of opened/partial doses, the DEA emphasized that the new rule applies to unopened inventory only. MORE
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Industry News


HHS Secretary Announces $840 Million Initiative to Improve Patient Care and Lower Costs
HHS News Release (10/23/14)

The Department of Health and Human Services (HHS) announced on Oct. 23 an $840 million initiative to help improve medical care and reduce costs. "The administration is partnering with clinicians to find better ways to deliver care, pay providers and distribute information to improve the quality of care we receive and spend our nation's dollars more wisely," said HHS Secretary Sylvia M. Burwell. "We all have a stake in achieving these goals and delivering for patients, providers and taxpayers alike." The grant program will fund successful applicants who work directly with medical providers to rethink and redesign their practices. Possible strategies include giving doctors better access to patient information, increasing the number of ways patients are able to communicate with the clinicians taking care of them, and improving the coordination of patient care by primary care providers and specialists.
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The Incredible Cost Savings That Are Possible When Patients Can Actually Shop Around
Washington Post (10/21/14) Millman, Jason

A new study by Castlight Health reveals that as consumers with private coverage shoulder more of their health care costs, they are likely to search for a better deal if they are able to compare prices. Study participants had access to prices for advanced imaging services, CT scans, and clinician office visits through Castlight's transparency platform, spelling out their out-of-pocket costs based on their health plan and deductible status. With data on more than 500,000 people nationwide covered by employer plans, the study found that average payments were lower for all three services for consumers who searched on the transparency platform. The savings related to price searches averaged 13 percent for advanced imaging tests, 14 percent for laboratory tests, and 1 percent for clinician office visits.
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AMA's Steven Stack on ICD-10: The Sky's Not Falling, But at Times It Feels Like It
Fierce HealthIT (10/23/14) Dvorak, Katie

Increased regulation and changing policies, such as Meaningful Use to the Physician Quality Reporting System and ICD-10, are becoming serious hindrances for health-care providers, says American Medical Association (AMA) President-Elect Steven Stack. At the Workgroup for Electronic Data Interchange's annual fall conference, Stack pointed out problems with the ICD-10 coding system, which has already been delayed several times. Challenges include an overabundance of codes, the need for additional data that providers may lack, and higher costs for providers. The AMA has proposed a grace period that forbids payers from denying payment or doing "take backs" due to imprecise coding.
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More Plans Setting Spending Limits for Some Medical Services
Kaiser Health News (10/21/14) Andrews, Michelle

In an effort to limit how much they will pay for certain medical services, an increasing number of insurers and employers are adopting reference pricing. More than three years ago, the California Public Employees' Retirement System (CalPERS) started using reference pricing for elective knee and hip replacement surgeries, working with Anthem Blue Cross and setting $30,000 as the reference price for the procedures in its preferred provider organization plan. While members who undergo surgery at one of the 52 hospitals that charge $30,000 or less need only pay their health plan's standard cost-sharing, members who go to an in-network facility that charges more than $30,000 must pay the entire amount over that sum, and the extra amount does not count toward their maximum out-of-pocket limit for the year. CalPERS recently set limits on how much it would spend for cataract surgery, colonoscopies, and arthroscopic surgeries as well. Reference pricing is best for common, non-emergency procedures and tests that may vary significantly in prices but are fairly comparable in terms of quality, according to experts. Opponents say the strategy may only have modest savings for employers, however.
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Insurers' Consumer Data Isn't Ready for Enrollees
New York Times (10/26/14) P. A21 Pear, Robert

In a recent bulletin to health insurers, the Obama Administration said it will delay requirements for them to disclose data on the number of enrollees, the number of claims denied, and the costs to consumers for certain services under two sections of the Affordable Care Act requiring "transparency in coverage." The administration said it would not enforce these requirements until further guidance is issued. "We expect this will begin after a full year of claims data is available," said Centers for Medicare & Medicaid Services spokesperson Aaron Albright. However, the delay has disappointed consumer advocates who believe the data would help consumers shop for coverage during the upcoming open enrollment period.
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CMS Improves the Doctor Payment Website
Wall Street Journal (10/17/14) Loftus, Peter

The Centers for Medicare and Medicaid Services (CMS) has changed its Open Payments website to allow consumers and others to more easily search for payments made by drug and medical devicemakers to doctors and teaching hospitals. The search tool, which was introduced in beta form, allows users to search for payments by entering a physician's name, location or specialty. The names of teaching hospitals and companies can also be entered to find payments. In addition, the search tool allows users to sort payments in ascending and descending order and group them by three categories: general payments, research payments and ownership in companies. The tool is seen as an improvement over the search boxes that were included in spreadsheets containing payment information. While CMS still has not corrected all of the erroneous payment information contained in the website, the agency plans to do so before the end of the year.
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New Research Center Aims to Develop Second Generation of Surgical Robots
New York Times (10/23/14) Markoff, John

Scientists at the University of California, Berkeley, have received funding from the National Science Foundation and two private donors to establish the new Center for Automation and Learning for Medical Robotics. This research center will help develop advanced medical robots that can perform low-level, repetitive surgical tasks so that doctors can focus on the more challenging steps of an operation. While robots can perform some surgical tasks on bone, such as certain aspects of hip and knee replacements, researchers have not yet developed fully automated robots that can perform surgery on soft tissues. For example, the da Vinci surgical robot, developed by Intuitive Surgical, gives high levels of precision to the surgeons who operate it, but it does not automate surgical tasks.
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Opinions on Certificate of Need Program Run Gamut
Enquirer Herald (S.C.) (10/21/14) Holleman, Joey

Opinions vary widely on South Carolina's Certificate of Need (CON) system for health care entities, meant to prevent over-saturation of health care capacity and reduced quality. The South Carolina Hospital Association and the South Carolina Health Care Association believe the process should be streamlined to keep expansion projects from being put on extensive hold, but some physician groups and ambulatory-surgery centers want to see the program significantly reduced or ended. Ann Margaret McCraw, CEO of Midlands Orthopaedics, argues that the CON process raises health care costs by encouraging the status quo. New, cost-efficient ambulatory surgery centers, for example, may struggle to get a required CON to compete with hospitals for patients. A House Certificate of Need Ad-Hoc Committee, chaired by Rep. Murrell Smith (R-Sumter), is expected to recommend legislative changes to the CON process.
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