ASCA News Digest (September 3, 2014)

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September 3, 2014





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ASCA Highlights


Early Registration Deadline Extended for ASCA's Fall Seminar

ASCA members can now take advantage of early registration discounts through Monday, September 15, for ASCA's 2014 Fall Seminar, October 9-11, in Scottsdale, Arizona (just 15 minutes from the Phoenix airport). Attend one, two or all three days of the seminar to design an itinerary built to fit your budget and travel schedule. Live near Scottsdale? ASCA has partnered with Avis Rental Car to offer you discounted rates up to 30%. MORE
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Stay up-to-date on your peers' latest career and industry updates and announcements with ASCA's new 'Names in the News' webpage. Read the 2013/2014 National APEX Quality Award winners for health care excellence and find out who has been named LifeLinc Anesthesia's General Counsel. Send us your news at editorial@ascassociation.org. MORE
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The clinical and operational benchmarking report for the second quarter of 2014 (Q2) is now available for ASCA Benchmarking subscribers. Subscribers can access the Q2 report by logging in to the ASCA Benchmarking portal and clicking on the Reports page. MORE
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When ASCs are able to benchmark themselves against credible, data-driven benchmarks, they establish a baseline from which their performance can be measured. This enables ASCs to see where they lag, operate as expected or, hopefully, lead. ASCs that are not yet benchmarking or doing so well will likely face significant challenges. MORE
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To assist surveyors in assessing compliance of sterilization practices in surgical settings
with Medicare health and safety standards for hospitals, Critical Access Hospitals (CAHs)s and Ambulatory Surgical Centers (ASCs), CMS is providing an update to S&C Memorandum 09-55 regarding the use of “flash” sterilization. MORE
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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.

Due to high demand, ASCA has obtained 10 additional hotel rooms for the September Capitol Fly-In. Click here to register (ASCA will make all hotel reservations). The Fly-In will take place September 9-10, at the Hyatt Regency Capitol Hill. MORE
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Earlier this week, ASCA representatives met with CMS Administrator Marilyn Tavenner and senior staff from CMS to discuss issues of concern to the ASC community. ASCA representatives touted the ASC community’s strong participation in the Medicare ASC Quality Reporting Program and discussed how the growing disparity in ASC and hospital outpatient department (HOPD) payments could discourage ASCs from participating in the Medicare program. 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.

Industry News


CMS Announces Three Weeks of ICD-10 Acknowledgement Testing
Health Data Management (08/29/2014) Slabodkin, Greg

The Centers for Medicare and Medicaid Services (CMS) announced that it will hold three separate weeks of ICD-10 acknowledgement testing starting later this year. The three testing weeks are: November 17-21, 2014; March 2-6, 2015; and June 1-5, 2015. CMS noted that ICD-10 acknowledgement test claims can be submitted anytime until the new planned implementation date of Oct. 1, 2015, but it is hoping that designating the three weeks for testing will "generate awareness and interest" and "instill confidence" in the provider community that both CMS and Medicare Administrative Contractors (MACs) are prepared for the shift to ICD-10. According to CMS, "These testing weeks will allow trading partners access to MACs and [Common Electronic Data Interchange contractor] for testing with real-time help desk support. The event will be conducted virtually and will be posted on the CMS website, the CEDI website and each MAC's website."
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Facing an Uncertain Future, Physicians Increasingly Throw in the Towel
D Healthcare Daily (Dallas) (08/27/14) Jacob, Steve

Orthopedic surgeons' Medicare reimbursement declined by an estimated 28 percent from 1992 to 2007, according to the American Academy of Orthopaedic Surgeons (AAOS). Commercial insurance reimbursement has similarly fallen, and new regulations have introduced costly hurdles that are compelling many practices to shut down. The AAOS notes that hospital employment of orthopedic surgeons tripled from 2004 to 2010. A survey by Accenture of U.S. doctors found that of those who expect to remain independent, one out of three said they intend to implement a subscription-based care model, such as concierge or direct-pay practices. Accenture predicts that subscription-based models could double annually for the next three years.
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A New Playbook for Hospitals: How Investors Pursue a Financial Turnaround
NorthJersey.com (08/24/14) Washburn, Lindy

An increasing number of struggling hospitals in New Jersey are being purchased by for-profit companies, whose owners may use strategies like aggressive billing and real-estate swaps to generate profits. In the case of Meadowlands Hospital Medical Center in Secaucus, N.J., the number of same-day patients coming in for services increased, but the hospital’s outpatient charges for procedures like steroid back injections and knee surgery significantly exceeded the charges permitted at ambulatory surgery centers, according to insurers' testimony at a 2012 legislative hearing. The state attempted to impose a similar fee schedule for procedures in hospital settings, but encountered opposition from surgeons, anesthesiologists, and Meadowlands. The proposed fee regulations were eventually applied to many fewer procedures.
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Financial and Quality Impacts of the Medicare Physician Group Practice Demonstration
Medicare & Medicaid Research Review (08/22/14) Pope, Gregory; Kautter, John; Leung, Musetta; et al.

A recent study sought to assess the effect of the Medicare Physician Group Practice (PGP) demonstration on expenditure, utilization, and quality outcomes. The researchers focused on Medicare claims assigned to 10 participating provider organizations before and after the demonstration period. They found that the 10 demonstration sites combined saved $171 per assigned beneficiary person year during the 2005-2010 demonstration period, while Medicare paid performance bonuses to the participating PGPs averaging $102 per person year. The demonstration improved quality of care as measured by six of seven claims-based process quality indicators. The researchers concluded that the PGP demonstration led to small reductions in Medicare expenditures and inpatient utilization as well as improvements in process quality indicators.
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Joint Commission Issues Alert on Tubing Misconnections
Medscape (08/21/14) Brooks, Megan

The Joint Commission will proactively aim to reduce the potential for accidental medical tubing misconnections when new tubing connectors are introduced beginning this October. In a Sentinel Event Alert, the commission cites a high risk for tubing misconnections, given that nearly all patients admitted to the hospital and many in other health care settings will get an intravenous infusion. Joint Commission CEO Mark R. Chassin notes, "Organizational leadership is the first line of defense in this transition to the new connectors." Strategies the commission offers to help prepare for the new ISO standards include evaluating and managing current risks for injury; evaluating and adapting existing systems, processes, and protocols to carefully switch to the new ISO connectors; effective processes and procedures for misconnection prevention; and deployment of safe practices for the administration of high-alert medications.
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Bundled Payments for Colonoscopy Inevitable--But Maybe Not a Bad Thing
Gastroenterology & Endoscopy News (08/14) Vol. 65, No. 8 Helwick, Caroline

Amid declining reimbursement for colonoscopies, gastroenterologists (GIs) should consider alternative payment models in their negotiations with payors and health systems, suggests John Allen, president of the American Gastroenterological Association Institute. These models include bundled payments and multidisciplinary medical homes for high-risk patients. GIs and their organizations also need to define the "risk corridors" within these bundles, Allen says. For instance, if GIs include post-polypectomy bleeding in their care bundle, the risk corridor would be broader than one limited to when patients are discharged from the endoscopy unit. "The wider the corridor, the greater the risk to the practice--but also the greater the reimbursement per procedure," Allen notes. "A highly technical practice should be able to define the number of events in a particular component and then be able to 'price' that."
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ASGE Supports Pilot Program Aimed at Improving Colorectal Cancer Screening Rates and Access to Specialty Care in Community Health Centers
American Society for Gastrointestinal Endoscopy (08/27/2014)

Colorectal cancer is the third-leading cause of cancer death in the United States, and an estimated 136,000 adults will be diagnosed with the disease this year. The National Colorectal Cancer Roundtable has launched a new program to improve colorectal cancer screening rates and access to specialty care. A partnership that includes the American Society for Gastrointestinal Endoscopy will provide three locations with $100,000 each to launch pilot programs focused on improvement of screening rates and follow-up care for patients in community health centers. The program intends to reach 80 percent of adults age 50 and over receiving regular screening for colorectal cancer by 2018.
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Website Offers Medical Cost Comparisons for W.Va.
Charleston Gazette (WV) (09/01/14) Nuzum, Lydia

A new website offers health care cost comparisons for common procedures for hospitals in six states, including West Virginia. Launched by Dr. Bill Hennessey, a practicing physiatrist in Greensburg, Pa., who also sees patients in Morgantown, W.V., the www.pratter.us site aims to make health care costs more transparent. Hennessey notes that many consumers are not aware of their options, including hospitals, ambulatory surgery centers, and independent imaging centers. The site is searchable by zip code, providing data that Hennessey obtained for each facility via public disclosures and then "translated ... from medical speak to English."
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Outpatient Surgery Now at Strong West
Rochester Democrat & Chronicle (NY) (08/27/14) Singer, Patti

UR Medicine's Strong West ambulatory surgery center in Brockport, N.Y, is scheduled to open Sept. 2 after the facility received approval from the state Department of Health. The 15-bed ambulatory surgery center has its own medical director and nurse director, three operating rooms, and two procedure rooms. Procedures to be performed will be in the fields of general surgery, ophthalmology, orthopedics, and urology. UR Medicine and private-practice physicians will use the facility, which will serve as an outpatient hub for western Monroe and eastern Orleans counties.
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Oklahoma Doctor Making a Run Around Obamacare
Watchdog.org (08/26/14) Ginsparg, Shalva

Patients of the Surgery Center of Oklahoma, a physician-owned clinic in Oklahoma City, usually pay in cash or with cashier's checks, as the center does not accept Medicare or Medicaid and very selectively works with private insurance plans. Dr. Keith Smith, the center's director, notes that Obamacare enrollees are one of his fastest-growing patient groups, citing both higher prices and doctor shortages. The Surgery Center of Oklahoma posts all the prices its surgeries online, along with infection rates, and Smith believes that such transparency is connected to quality and efficiency. Dr. James Totoro, a general surgeon at the Surgery Center, notes that doctors there are scheduled based on surgeries, not shifts, and the center's efficient paper documentation system allows doctors to spend more time with patients and less time at the computer.
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Blog: CBO Projects Lower Medicare and Medicaid Costs
Kaiser Health News (08/27/14) Carey, Mary Agnes

On Aug. 27, the Congressional Budget Office (CBO) reduced its 10-year cost projections for Medicare and Medicaid by $89 billion, citing lower costs for medical services and labor. In an update to its April forecast, the CBO said Medicare spending will fall by $49 billion, or less than 1 percent, and Medicaid spending will decrease by $40 billion, or about 1 percent, from 2015 to 2024. However, the CBO expects federal spending for major health care programs to increase 9 percent, or $67 billion, this year, with Medicaid spending expected to jump 15 percent, or $40 billion, mainly due to the Affordable Care Act. Medicare outlays should rise 2 percent, or $12 billion, this year, on par with 2013 growth and less than the increase in Medicare beneficiaries.
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A Study of the Efficacy of Flashing Lights to Increase the Salience of Alcohol-Gel Dispensers for Improving Hand Hygiene Compliance
American Journal of Infection Control (08/01/2014) Vol. 42, No. 8, P. 852 D'Egidio, Gianni; Patel, Rakesh; Rashidi, Babak; et al.

The use of blinking red lights attached to alcohol gel dispensers was investigated as a way to improve hand hygiene in hospitals. The dispensers, whose lights flashed at 2-3 Hz (flashes/second), were located in the hospital's lobby. Using baseline and intervention observations over five 60-minute periods during weekday mornings, the findings indicate that baseline hand hygiene compliance was 12.4 percent, but the intervention increased compliance to 23.5 percent during cold weather and 27.1 percent during warm weather. The overall pooled compliance rate increased to 25.3 percent, suggesting that a simple, low-cost flashing red light placed on alcohol gel dispensers helped to roughly double overall hand hygiene compliance.
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