ASCA News Digest (September 16, 2014)

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September 16, 2014





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ASCA Highlights


Learn the 2015 Coding Essentials at ASCA's Coding Seminar

Save the date for ASCA’s 2015 Winter Coding Seminar, January 22-24, 2015, in San Diego, to ensure that your ASC is prepared for 2015’s coding and billing changes. This two-and-a-half day conference is a "must" when it comes to learning best coding practices that assure you receive the reimbursements you deserve. MORE
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The digital edition of the October issue of ASC Focus is now available. Read the latest issue to learn how to use breakeven analysis effectively, advanced strategies for reducing salary costs in an ASC, whether or not your ASC should have a social media policy, a review of Medicare's 2015 ASC payment proposal and the many regulatory and legislative victories that ASCA's advocacy efforts have achieved this year. 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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The Centers for Medicare & Medicaid Services (CMS) is collaborating with the American Academy of Professional Coders (AAPC) on a “code-a-thon” event to help providers and industry professionals learn about ICD-10. The code-a-thon will take place Monday, September 15, 2014, from 1:00 pm to 4:45 pm ET. 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. MORE



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58 ASCA members from 18 states met with their members of Congress on Capitol Hill last week for the final event of this year’s Capitol Fly-In Program. The Fly-In attendees conducted 102 meetings with congressional offices to directly lobby for pro-ASC legislation and 32 of the meetings were with the members of Congress themselves. MORE
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Industry News


Surgery Prices Surge With Innovation and Consolidation Under Obamacare
NBC News (08/31/14) Briggs, Bill

The Dartmouth Institute's John Birkmeyer estimates that surgery is now a $500 billion industry in the United States, comprising 80 million to 100 million procedures performed annually. Researchers and physicians attribute the rising cost of surgery to hospital consolidations that create medical monopolies as well as innovative yet costly technologies. Data from the Healthcare Bluebook reveals that gall bladder removal has increased 21 percent since 2009, with a "total fair price" of $5,532; the price of a hysterectomy has increased 19 percent, to $11,780; and hip replacement is up 24 percent, to $22,606.
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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.
Why Should You Participate in ICD-10 Acknowledgement Testing?
EHR Intelligence (09/02/2014) Bresnick, Jennifer

Health care organizations have an additional 13 months to prepare for migration to ICD-10 coding, until Oct. 1, 2015. The Centers for Medicare & Medicaid Services announced recently three separate weeks of acknowledgement testing. Providers may engage in acknowledgement testing at any time until the implementation date, but the three dedicated weeks will allow organizations to access extra help from Medicare Administrative Contractors (MACs). Providers should sign-up with their MAC for one or more of the testing opportunities because only 89 percent of claims were successfully accepted in March of 2013 for an ICD-10 dry-run. Repeated testing is necessary in light of technical upgrades and new software installations as well as ongoing education for administrative staff involved in claims and billing.
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Need Outpatient Surgery?
Virginia Health Information (09/10/2014)

Consumers can now learn more about commonly performed outpatient procedures in Virginia through a free online guide from Virginia Health Information (VHI). VHI collects outpatient procedure information from more than 300,000 outpatient surgeries reported in 2013, an increase of 1.4 percent from 2012. The guide provides information on 10 types of diagnostic and surgical procedure groups--including general laparoscopic procedures, hernia repair, hysterectomy, and colonoscopy--based on factors like actual or perceived risk, frequency, and cost. For certain procedure groups, VHI lists the average statewide amount health insurance companies approve for payment.
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Considering Surgery? Some Healthcare Providers Offer Warranties
Los Angeles Times (09/14/14) Zamosky, Lisa

A small but growing number of providers is offering warranties on surgical procedures. In Danville, Pa., Geisinger Health System became the first to offer warranties for cardiac surgeries, and it now also offers warranties for hip fractures and total hip and knee replacements. Meanwhile in Seattle, Virginia Mason Hospital recently said it would provide warranties to privately insured patients undergoing joint replacement surgeries. "What is really in progress here is a shift from the standard … fee for service to innovative forms of payment which reward value on the part of the providers," says Dr. Michael Belman, medical director at Anthem Blue Cross. "That is where the future appears to be, as directed by the Affordable Care Act." Although the warranties may differ in terms of their coverage, generally they guarantee to fix any avoidable surgery-related complications at no added cost to the patient.
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Streamlined Doc-Licensing Process Offered to States
Modern Healthcare (09/05/14) Robeznieks, Andis

In a move seen as facilitating the growth of telemedicine and speeding increased healthcare access to residents in rural areas, the Federation of State Medical Boards has released model legislation that could be used to create a multistate agreement or "compact" system, under which doctors who are licensed in one state could use a streamlined process to be quickly licensed in another state. The Wyoming State Board of Medicine spearheaded the effort, and Executive Director Kevin Bohnenblust said states like his are accustomed to interstate compacts. The legislation calls for at least seven states to participate in the compact and for participating states to have representatives on a governing commission. Once enough states have joined the effort, participating states would share credential and disciplinary information on physicians licensed by their states with other states to facilitate the speedy issue of licenses. American Medical Association President Dr. Robert Wah said the compact model "aligns with our efforts to modernize state medical licensure."
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Feds Reverse Course, Will Release Hospital Mistake Data
USA Today (09/07/14) O'Donnell, Jayne

The U.S. Centers for Medicare and Medicaid Services (CMS) will again make data on eight hospital-acquired conditions available on its website. CMS stopped publicly reporting the information last month after denying in 2013 that it would do so. The data was still available to quality researchers, patient safety advocates, and consumers on a public spreadsheet. The data is expected to be posted online later this year. The move comes amid growing calls for increased transparency for hospitals. "I commend CMS for their commitment to transparency," Leah Binder, CEO of The Leapfrog Group, said. "This is good news for the public."
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Proposed Physician Fee Schedule Draws Criticism From Docs, Insurers
Modern Healthcare (09/11/14) Dickson, Virgil

The Centers for Medicare and Medicaid Services' (CMS) proposed 2015 physician fee schedule has sparked widespread criticism from health care stakeholders, with the Medicare Payment Advisory Commission (MedPAC) questioning CMS' strategy of adjusting payments to doctors based on the quality of care furnished to beneficiaries rather than the cost of care. MedPAC's comment letter suggests that CMS' approach could foster mass confusion because physicians are likely not to understand why their Medicare payments are changing and what action they must take to improve their performance and boost their quality-based payments. "A more promising avenue would be to encourage clinicians to organize into or join groups that take clinical and financial accountability for their patients, and have their performance assessed on the basis of a few key outcome measures," MedPAC said. Moreover, with hospitals acquiring physician groups, the American Hospital Association (AHA) has raised issues about CMS' planned collection of data concerning billing for hospital fees for services delivered to the same outpatient setting as before the practice's acquisition. The AHA says "operational issues must be settled and adequately tested before full-scale implementation, and adequate time must be allotted for hospitals to adjust and operationalize their systems to accommodate this proposed change."
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Physicians Realty Trust Announces $20.7 Million Acquisitions During September and $180 Million in Pending Acquisitions Under Contract
Business Wire (09/08/2014)

Physicians Realty Trust finalized two acquisitions totaling $20.7 million in early September, one of which is a 15,662-square-foot surgery center located in Mansfield, Texas. The building is occupied by Baylor Surgicare at Mansfield, a multi-specialty surgery center owned by a joint venture of more than 20 surgical specialist physicians, United Surgical Partners, Inc., and an affiliate of the Baylor Scott & White Health Care System. Physicians Realty Trust also finalized the purchase of the Eye Center of Southern Indiana in Bloomington, Ind. The Eye Center is a 32,096-square-foot medical office building and ambulatory surgical center that is occupied by the physicians of the Eye Center of Southern Indiana.
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Groups Press FDA to Encourage Medical-Device Registries
Modern Healthcare (09/03/14) Lee, Jaimy

The Pew Charitable Trusts, the Blue Cross and Blue Shield Association, and the Science Infrastructure Center have issued a set of recommendations to the Food and Drug Administration (FDA) aimed at improving the role of medical device registries in the United States. Device registries, which track the among other things the performance record of medical devices, are relatively common outside the country and have played a major role in identifying devices with substandard performance. Pew and its fellow organizations want to see a larger role for public device registries in the United States, though they acknowledge that not all devices need to be tracked through a registry. In their recommendations to the FDA, they say that factors including cost of maintenance and the value of the information gathered should be considered when setting up any given device registry.
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APIC Provides Input to CMS on Hospital Outpatient, ASC, and ESRD Payment Rules
Association for Professionals in Infection Control and Epidemiology (09/03/2014)

The Association for Professionals in Infection Control and Epidemiology has submitted comments to the Centers for Medicare & Medicaid Services on infection-related provisions in the calendar year 2015 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (OPPS/ASC) and the End-Stage Renal Disease Facility Prospective Payment System proposed rules. The comments on OPPS/ASC were submitted jointly with the Society of Healthcare Epidemiology of America, and addressed such issues as removing "topped-out" measures for quality reporting programs and clarifying data submission deadlines and reporting requirements for health care personnel's influenza vaccination. The comments also recommended a continued focus on exploring a meaningful way to collect data about health-care associated infections in ASCs in the future.
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The Preventive Surgical Site Infection Bundle in Colorectal Surgery
JAMA Surgery (08/27/2014) Keenan, Jeffrey E.; Speicher, Paul J.; Thacker, Julie K. M.; et al.

A preventive bundle can help reduce the rate of surgical-site infections (SSIs) after colorectal surgery, reducing hospital stays and health care costs. Duke University Medical Center implemented a preventive SSI bundle on July 1, 2011, and examined its effects on SSI rates, wound disruption, sepsis, length of hospital stay, readmission, and costs. The study included 559 patients who underwent major elective colorectal surgery, including 346 who received the surgery before the bundle and 213 who received the surgery after the bundle. While there were no significant differences in deep SSIs, wound disruption, or 30-day readmission, a subgroup analysis found that superficial SSI occurrence was associated with a 35.5 percent increase in variable direct costs and a 71.7 percent increase in length of stay.
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