ASCA News Digest (September 9, 2014)

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September 9, 2014





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ASCA Highlights


Find Out Why ASCA's Fall Seminar Is Invaluable for All ASC Staff

ASCA's 2014 Fall Seminar will offer educational sessions on key topics that drive development and daily operations at your ASC, lively networking opportunities, continuing education contact hours and the CASC Review Course and Exam. The seminar will take place October 9-11, in Scottsdale, Arizona (just 15 minutes from the Phoenix airport). Early registration discounts are available through Monday, September 15. MORE
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A new resource that discusses the many ways that ASCs demonstrate their commitment to quality care and patient safety is now available on ASCA’s web site. The web page discusses state and federal regulatory requirements, accreditation standards, licensing requirements, Medicare certification, quality reporting and more. MORE
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ASCA is currently recruiting ASCs to participate in the 4th cohort of a national patient safety improvement program. This 12-month program is designed to improve communication, teamwork and quality in outpatient surgery facilities. It focuses on effectively implementing a surgical safety checklist as a means of reducing infections and complications and, in the process, offers multiple benefits and resources to your ASC.

Improper inventory management in an ASC can lead to financial and operational ruin. The reason that a facility loses money or reschedules too many cases can often be traced back to poor inventory management. To help surgery centers create a more efficient, accurate inventory management program, consider these strategies. MORE
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Dallas, Texas-based Surgical Notes, a provider of transcription, coding and document management services for ASCs and surgical hospital markets, has appointed Chuck Meisel as vice president of sales. Stay up-to-date on all of your peers' latest career and industry updates and announcements with ASCA's new 'Names in the News' webpage. Send us your news at editorial@ascassociation.org. 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.

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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ASCA submitted its formal comment letter in response to the Centers for Medicare & Medicaid Services (CMS) 2015 proposed payment rule, which among other payment policies, proposes the reimbursement rates for the coming year. ASCA also submitted comments this year in response to the physician payment rule. 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


Challenges and Remediation for Patient Safety Indicators in the Transition to ICD-10-CM
Journal of the American Medical Informatics Association (09/03/14) Boyd, Andrew D.; Yang, Young Min; Li, Jianrong

There are risks of under- and over-reporting adverse effects with the shift to ICD-10, according to new research. The researchers looked at 23 types of Patient Safety Indicators (PSIs) and, using the General Equivalent Mappings, compared the accuracy of ICD-9 coded PSIs against recommended ICD-10 codes. Overall, they found three PSIs that had straightforward mapping between the two coding systems, but 15 PSIs had convoluted mapping and five had no mapping at all. The authors note that the ICD-10 translations proposed by the Centers for Medicaid and Medicare Services pose possible risks for comparing safety incidents, inflating the number of PSIs, and raising the variability of calculations attributable to the abundance of coding system translations. According to the authors, "Publicly listing the new and removed PSIs early will help to inform the public about the changes and use of national hospital comparison data for patient safety."
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Officials Tout Surgery Center Cost Savings
Eau Claire Leader Telegram (09/02/14) Vetter, Chris

Independent Surgery Center in Lake Hallie, Wis., recently hosted an open house to highlight the savings of ambulatory surgery centers (ASCs). Officials at the 3,000-square-foot center noted that the average facility charge for cataract surgery is about $2,500, which can save money both for Medicare and consumers, when compared with hospitals. Steve Miller, chief operating officer for the Ambulatory Surgery Center Association (ASCA), said he envisions that more types of spine, knee, and hip surgeries will be available at small ASCs. "We think there is a huge upside to moving more complicated procedures over to ASCs," he said. "Patients don't want to be in a hospital bed." Miller noted that ASCA wants to secure federal legislation to ensure that Medicare reimbursement rates for ASCs increase at the same level as rates for hospitals.
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Report Examines Technologies for Monitoring the Quality of Endoscope Reprocessing
American Society for Gastrointestinal Endoscopy (09/03/2014)

The American Society for Gastrointestinal Endoscopy (ASGE) has issued a report on technologies for monitoring the quality of endoscope reprocessing. Reprocessing was detailed in the 2011 Multisociety Guideline on Reprocessing Flexible Gastrointestinal Endoscopes. But the ASGE notes that while "effective surveillance of flexible endoscope reprocessing ideally requires testing methods that allow for rapid assessment of compliance with current reprocessing standards, ... the lack of both widely accepted bioburden/microbial benchmarks and widely validated means of assessing these has limited implementation of such strategies." Potential methods for surveillance include culturing for bacterial load, evaluating residual bioburden and organic matter, and adenosine triphosphate (ATP) bioluminescence testing. Areas for future research include setting and validating standardized bioburden/microbial benchmarks and ATP bioluminescence thresholds after reprocessing of flexible endoscopes and assessing the cost-effectiveness of implementing surveillance strategies for monitoring the quality of endoscope reprocessing.
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Porter Health Care System Wins National Quality Award for Fourth Straight Year
Michigan City News-Dispatch (09/07/14)

For the fourth straight year, Porter Health Care System's Chandana Surgery Center, located in Valparaiso, Ind., has won an APEX Quality Award. Darlene McCrammer, director of Chandana Surgery Center, notes: "In an outpatient setting, we care for patients for only a short time, so we have a limited window to ensure their stay with us meets their expectations and is pleasant. Our staff members are very experienced in surgery and recovery and put our patients at ease, knowing they are in good hands." The award, which stands for Attributes for Patience Excellence Award, is given to free-standing ambulatory surgery centers that demonstrate the highest level of excellence in patient satisfaction. Nationwide, a total of 90 facilities received the award this year.
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CMS Shuts Down Sunshine Act Database--Again
MedPage Today (08/29/14) Frieden, Joyce

The Centers for Medicare and Medicaid Services (CMS) has announced that it will once again take the Open Payments database, which details payments made to physicians by drug and device companies, offline for maintenance. The database, developed as a result of the Physician Payments Sunshine Act, has had several recent problems, including going offline to resolve a problem that was switching records for physicians with similar names, and a data integrity problem with prevented data on payments made indirectly through contract research organizations from being posted online. The American Medical Association (AMA) says the most recent shutdown adds to growing concerns that the site is not ready for the public. CMS says it is still committed to having the database open to the public on September 30, but the AMA and 100 other physician groups have been pushing for a delay to give physicians more time to register and review the accuracy of their data.
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Laser Spine Institute Plans to Build New Headquarters, Ambulatory Surgery Center in Avion Park, Tampa
AZoBuild.com (09/05/14)

Laser Spine Institute plans to construct a 176,000 square-foot facility for its headquarters and an ambulatory surgery center in Tampa, Fla. The move is expected to create more than 100 new jobs and extend treatment options to 25 percent more patients. In 2013 alone, Laser Spine Institute had an economic impact of more than $220 million in the Tampa Bay area. "The expansion of Laser Spine Institute, including a new corporate headquarters and spine surgery center in Tampa, is an exciting development for Florida's economy,” said Florida Gov. Rick Scott. Construction of the facility is expected to begin this fall and be completed in the first quarter of 2016. The company also plans to open new centers in Cleveland, Cincinnati, and St. Louis.
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Stormont-Vail's New Surgery Center Is Good for City
Topeka Capital-Journal (KS) (09/02/14)

Stormont-Vail HealthCare expects to complete in late 2015 a $20 million new surgery and therapy center in Topeka, Kan., and this "is great news for the city, the local medical community and area patients," according to an editorial in the Topeka Capital-Journal. The roughly 87,000-square-foot building will have orthopedic and same-day surgery departments on the first floor, along with physical, occupational, and speech therapy on the second floor and doctors and midlevel providers on the top floor. The arrival of the new surgery center will offer more options for patients as well as increase job opportunities in the city. In 2013, Stormont-Vail HealthCare ranked as Topeka's second-largest employer, with 4,418 employees, according to information compiled by the Capital-Journal.
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Changes in Bariatric Surgery Procedure Use in Michigan, 2006-2013
Journal of the American Medical Association (09/03/14) Vol. 312, No. 9, P. 959

A new study on bariatric surgery procedures used in Michigan found that sleeve gastrectomy (SG) surpassed Roux-en-Y gastric bypass (RYGB) in 2012 as the most common procedure performed for patients seeking this type of surgery. Researchers analyzed data on more than 43,000 adults who underwent primary inpatient and outpatient bariatric surgery within the 39-hospital Michigan Bariatric Surgery Collaborative between June 2006 and December 2013. The relative use of SG increased from 6 percent of all procedures in 2008 to 67.3 percent in 2013, while the use of RYGB decreased from 58 percent to 27.4 percent and use of laparoscopic adjustable gastric banding decreased from 34.5 percent to 4.6 percent. "Although long-term outcomes of SG are still unclear, these changes may reflect the favorable perioperative safety profile and emerging evidence of successful weight loss at 2 to 3 years after SG," the authors write.
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Hackers Breach Security of HealthCare.gov
New York Times (09/05/14) P. A18 Pear, Robert; Perlroth, Nicole

The Obama Administration announced on Sept. 4 that hackers breached security of HealthCare.gov, but a spokesman for the Centers for Medicare & Medicaid Services says consumers' personal information was not stolen. The breach involved the download of malicious software on a HealthCare.gov test server as part of a broader denial-of-service attack, but the agency says consumer information was not stored on the server. According to the agency, the test server should not have been connected to the Internet, its default password had not been changed, and it had not undergone necessary and regular security scans. However, measures to strengthen security have since been undertaken by the agency.
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Key O-Care Premiums to Decrease, Study Finds
The Hill (09/05/14) Viebeck, Elise

A new study by the Kaiser Family Foundation indicates that in 15 major cities next year, the average premium for a benchmark Obamacare plan--the second-lowest-cost silver plan used to determine tax credits--will drop by 1 percent on average. Rate changes will range from an 8.7 percent increase in Tennessee to a 15.6 percent decrease in Denver. Researchers note that opting against auto-renewal and switching plans could enable enrollees to dramatically lower their premiums, especially as estimated tax credits are expected to remain at 2014 levels.
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Bracing for New Challenges in Year 2 of Health Care Law
New York Times (09/03/14) P. B1 Abelson, Reed

Troubles with HealthCare.gov and confusion among consumers are just a couple of the problems reported during the Affordable Care Act's first open enrollment period, and insurers are worried that the upcoming open enrollment period for 2015 will be even more difficult. The Obama Administration hopes another 5 million people will sign up for coverage, but this time around, they have only three months, rather than six, to select a new policy. Additionally, consumers will face wide disparities in price and new plans from which to choose, so many will shop around instead of automatically renewing their policies. Moreover, the process for renewal has not yet been detailed, leading many to expect more confusion the second time around.
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