ASCA News Digest (January 6, 2015)

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January 6, 2015





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ASCA Highlights


Q4 Now Open for ASCA Benchmarking

The data collection period for the fourth quarter (Q4) of the 2014 ASCA Benchmarking Program is now open. The collection period will close February 6. If you haven’t purchased your 2014 subscription yet, there is still time to sign up. Even though you are subscribing during Q4, you will still receive the national/specialty report for Q1, Q2 and Q3. MORE
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Learn how to accurately answer the new financial questions for ASCA Benchmarking, ASCA's clinical and operational benchmarking survey, and how to apply what you learn from the survey's report to bring about operational improvements in your ASC during ASCA's next webinar next Tuesday, January 13. ASCA Benchmarking subscribers can register for free. MORE
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ASCA's 2015 Winter Coding Seminar, January 22-24, in San Diego, is fast approaching but there is still time to sign up. Register today to ensure that your ASC is prepared for 2015’s coding and billing changes. This comprehensive program will cover coding tips for commonly performed ASC procedures, assessing coding accuracy and productivity, CPT changes that will take effect in 2015, ICD-10 and more. MORE
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The US Food and Drug Administration is alerting health care professionals not to use Wallcur, LLC, simulated intravenous (IV) products in human or animal patients. These products are for training purposes only. There have been reports of serious adverse events associated with the use of certain of these products – i.e., Practi IV Solution Bags. MORE
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Personnel turnover affects a vast number of financial and operational issues and lowers productivity. When you lose an employee, you also lose their historical knowledge of your ASC and learned competencies. In addition, the staff who remain have to take on extra responsibility to fill in and, in the process, feel overworked. MORE
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ASCA has partnered with HealthStream to offer a collection of 21 courses that apply specifically to ASCs and are designed to train ASC staff on the most current regulations and standards of care. 16 of the interactive courses provide continuing education (CE) credit. Reduced prices are available through January 31, 2015. MORE
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CMS finalized a significant change to its device-intensive policy, pro-ASC legislation reached record levels of cosponsors and more than 150 members directly lobbied congressional offices as part of ASCA’s 2014 Capitol Fly-In Program and CMS removed the provision in the Conditions for Coverage requiring ASCs to have a radiologist on their medical staff. MORE
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Industry News


CMS Releases Quality of Care Data
Health IT Outcomes (01/01/2015) Kern, Christine

The Centers for Medicare and Medicaid Services (CMS) has released its data on the quality of care provided by hospitals, physician group practices, and Accountable Care Organizations (ACOs). Data suggest that care and outcomes for Medicare beneficiaries have improved in hospitals. The information includes hospital value-based purchasing programs, payment adjustments, updated performance results on diabetes and cardiovascular care by some physician group practices and ACOs, and performance results on hospital-acquired conditions such as central line-associated bloodstream infections and pressure ulcers. CMS recently announced that it will reduce payments by 1 percent to 721 hospitals for high rates of infections, which will affect one out of every seven U.S. hospitals and amount to an estimated $373 million in penalties.
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Insurers Gird for New Fight
The Hill (01/05/15) Viebeck, Elise

Health insurers are preparing for another fight with the Obama Administration over Medicare Advantage (MA) payments, as the administration is expected to issue new proposed payment levels for the program in February. There are concerns that it might lower payment rates to equalize per-capita spending between traditional Medicare and MA, but the industry insists that reductions will hurt seniors and is pushing for rates to remain stable. In response, the Coalition for Medicare Choices is courting incoming freshmen lawmakers and hoping lawmakers will use media appearances and letter-writing campaigns to put pressure on the administration.
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CMS Releases Results From ICD-10 Acknowledgement Testing Week
EHR Intelligence (12/23/2014) Murphy, Kyle

In its most recent testing of ICD-10 acknowledgement, the Centers for Medicare and Medicaid Services (CMS) found no problems with the Medicare Fee-for-service claims systems, but it did find a lower national rate of accepted test claims compared to results found in March. The ICD-10 acknowledgement testing ran the week of Nov. 17 and included more than 500 providers, suppliers, billing companies, and clearinghouses as well as nearly 13,700 claims. CMS reported in Medicare Learning Network Connects that acceptance rates improved during the week, reaching 87 percent for test claims. Nationally, CMS accepted 76 percent of total test claims. CMS verified that all test claims had a valid diagnosis code to match the date of service, a valid National Provider Identifier, and an ICD-10 companion qualifier code.
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Mass. Finalizes EHR Proficiency Regulations for License Renewals
iHealthBeat (12/29/14)

New rules adopted by the Massachusetts Board of Registration in Medicine require physicians to demonstrate meaningful use of electronic health record (EHR) systems in order to retain their medical licenses. Health care providers applying to the state's medical board for licensure must demonstrate proficiency in using EHRs along with computerized provider order entry and electronic prescribing. This includes completing a minimum of three hours of accredited continuing medical education training on EHRs that covers the meaningful use program's menu set and core objectives and clinical quality measures. Providers who renew their medical licenses prior to March 31, 2015, will receive a one-time exemption from the requirements.
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St. Cloud Surgical Center Is First ASC in U.S. to Utilize Xenex Germ-Zapping Robot to Disinfect Operating Rooms and Enhance Patient Safety
Business Wire (12/29/2014)

St. Cloud Surgical Center has become the first U.S. ambulatory surgery center to use a robot by Xenex Disinfection Services to destroy pathogens that can cause health care-associated infections. St. Cloud Surgical Center uses Xenex’s full-spectrum UV disinfection system, a portable robot, on its surgical suites every day. The center uses the system, which takes only 5-10 minutes to disinfect rooms, before and after total joint procedures and after any procedure on a patient known to have a dangerous infection. The Xenex robot pulses xenon, an inert gas, from a xenon ultraviolet flashlamp at high intensity, which produces broad-spectrum ultraviolet C to penetrate the cell walls of microorganisms and render them unable to reproduce or mutate.
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The Physicians Foundation Releases 2015 Physician Watch List
The Physicians Foundation (12/15/2014)

The Physicians Foundation has identified five areas that will affect physicians and patients in 2015. Increasing consolidation among hospitals and health systems will push smaller medical practices into larger systems, which could reduce competition and boost the emphasis on valued-based payment models. Half of the respondents to the foundation's 2014 Biennial Physician Survey said that ICD-10 will cause severe administrative problems in their practices, and 75 percent said it will unnecessarily complicate coding. As the lack of transparency regarding medical costs and billing practices becomes more frustrating, policy makers, payers, and providers may have to coordinate a system around cost-of-care transparency that is understandable for both patients and physicians. The survey also found that 44 percent of physicians plan to take actions that would reduce access to their services, such as cutting back on the number of patients, retiring, reducing their hours, or closing their practices.
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Highmark Drops Anesthesia Ban
Pittsburgh Business Times (12/22/14) Mamula, Kris B.

Rather than restricting the use of certain drugs in colorectal cancer screening, health insurer Highmark Inc. has instead decided to follow Medicare's lead on the issue. Highmark had planned to limit payment for administering propofol to high-risk patients, but it backed away from the decision in May as it continued discussions with organizations such as the Pennsylvania Medical Society, the Pennsylvania Society of Gastroenterology, and the Pennsylvania Society of Anesthesiologists. In a move to encourage screening for colorectal cancer, Medicare will waive co-insurance and deductibles for anesthesia or sedation services furnished in conjunction with screening colonoscopies, starting Jan. 1. Highmark will adopt Medicare's policy on the use of anesthetics during endoscopy procedures.
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Dilemma Over Deductibles: Costs Crippling Middle Class
USA Today (01/01/15) Ungar, Laura; O'Donnell, Jayne

An increasing number of middle-class workers are avoiding checkups and treatments due to high deductibles and other out-of-pocket costs. While many patients and doctors blame corporate greed and some employers blame the Affordable Care Act (ACA), health care researchers suggest that the trend is due to a steep rise in deductibles with stable premiums, stagnant wages, and corporate cost-cutting since the recession. Brian Marcotte, president and CEO of the Business Group on Health, says that one factor may be the ACA's "Cadillac tax" on high-cost coverage in 2018, but there have been issues with managing health care costs even before ACA. One surgeon in Massachusetts says his patients with high-deductible plans often avoid the out-of-pocket cost to electively treat common ailments such as gallstones and hernias until they become more dangerous, costly emergencies.
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87 Percent of People Who Selected 2015 Plans Through HealthCare.gov in First Month of Open Enrollment Are Getting Financial Assistance
HHS News Release (12/30/14)

About 87 percent of people who chose health-insurance plans through HealthCare.gov for coverage starting Jan. 1, 2015, were eligible for financial assistance to help lower their monthly premiums, according to a report from the Department of Health and Human Services (HHS). In comparison, 80 percent of enrollees who chose plans over a similar period last year were eligible. More than 4 million people in both the state and federal marketplaces signed up for or re-enrolled in coverage for 2015 in the first month of open enrollment. A Weekly Enrollment Snapshot from HHS shows that from Nov. 15 to Dec. 26, nearly 6.5 million consumers chose a plan or were automatically re-enrolled.
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