ASCA News Digest (September 13, 2016)

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September 13, 2016

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ASCA Highlights


Register for ASCA’s Coding and Reimbursement Strategies Seminar

As part of its three winter seminars taking place in San Antonio, Texas, January 12–14, 2017, ASCA will provide a program designed to help coders maximize reimbursements at their centers. Let the experts at ASCA’s Coding Update & Reimbursement Strategies Seminar walk you through how to prepare for the coding and billing changes to come in 2017 and discuss the changes that took place this year.

Visit the Coding Update & Reimbursement Strategies Seminar web site to learn more and register. ASCA members can save $200 by registering before December 13.
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Two days before Thanksgiving in 2013, a family member of a patient at Good Shepard Ambulatory Surgical Center entered the center and stabbed five people. The community around the center reeled from the incident, but eventually Good Shepard Ambulatory Surgical Center learned from it and became stronger.

Join ASCA’s next webinar to hear Beth Chrismer, RN, MSN, Good Shepard’s risk manager and a first responder at the incident share her experience and lessons learned to help you prepare for and avoid an incident of this kind in your ASC. This program will take place Tuesday, September 27 at 1:00 pm ET.
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Declining numbers of available operating room (OR) nurses have led some ASCs to develop their own perioperative RN training programs. Visit the ASC Focus web site to learn how other centers are preparing RNs without perioperative experience and new nurse graduates for the OR.
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Last week, ASCA submitted its formal comment letter in response to the Centers for Medicare & Medicaid Services’ (CMS) 2017 proposed payment rule, which contains proposals dealing with ASC reimbursement rates and payment policies for 2017.

Under CMS’s proposal, ASC rates would receive an across-the-board increase of 1.2 percent based on the Consumer Price Index for All Urban Consumers (CPI-U) while hospital outpatient departments (HOPDs) would receive an across-the-board increase of 1.55 percent based on the inpatient hospital market basket. In the comments, ASCA pressed CMS to align the two update factors to prevent a continuing divergence in payment rates by using the hospital market basket to determine the update factor for ASCs.
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Industry News


Hospital Ownership of Physician Practices Increases Nearly 90 Percent in Three Years
Physicians Advocacy Institute (09/07/16)

A new study prepared by Avalere Health finds that the number of physician practices owned by hospitals/health systems rose 86 percent between 2012-15, with the percentage of physicians employed by hospitals or health systems increasing in every region of the country during this time. Released by the Physicians Advocacy Institute (PAI), the analysis also finds that by mid-2015, 38 percent of U.S. physicians were employed by hospitals and health systems.
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Surgeries Often Lead to Huge Amount of Discarded and Unused Supplies
Fierce Healthcare (09/08/2016) Shinkman, Ron

Tens of thousands of surgeries take place in hospitals and other facilities every day. And it appears that clinicians discard huge numbers of unused medical supplies that are ordered for each procedure.
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Study: Using Ambulatory Centers Reduces Outpatient Costs
Society for Human Resource Management (09/09/16) Miller, Stephen

Encouraging health plan enrollees to use ambulatory surgery centers (ASCs) instead of hospital outpatient departments for common procedures can lower the cost of outpatient surgery, an analysis of health insurance claims found. The research concluded that ASC prices are significantly lower than hospital outpatient prices for the same procedures throughout the U.S.
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AW0380-PolicyStat Product Showcase  

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Independent Doctors Locked in Regulatory Battle With Hospitals
VT Digger (09/11/16) Mansfield, Erin

Independent doctors are fighting an uphill battle as they try to compete with two of the state's largest hospitals. Doctors have been seeking state approval for the Green Mountain Surgical Center for more than a year without success.
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Hospitals Use Chargemasters to Overcharge for Specialty Services
Fierce Healthcare (09/08/2016) Shinkman, Ron

Hospitals use their chargemasters and a relative lack of price transparency to overcharge for CT scans and other specialty services. That's the conclusion of researchers from Johns Hopkins University based on findings from 2013 Medicare cost reports.
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Out-of-Pocket Costs for Hospitalizations Rise Dramatically
Fierce Healthcare (09/08/2016) Shinkman, Ron

Commercially insured patients have seen their out-of-pocket costs increase dramatically in just a four-year period. Researchers at the University of Michigan studied 7.3 million medical claims from Aetna, UnitedHealthcare and Humana for hospitalizations that occurred between 2009 and 2013, with a focus on seven common inpatient medical procedures.
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CMS: Providers Choose Pace for Quality Payment Program in 2017
EHR Intelligence (09/09/2016) Murphy, Kyle

Well in advance of the final rule for the Quality Payment Program — comprising both the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) — the Centers for Medicare & Medicaid Services (CMS) has relaxed demands on eligible providers in 2017. "In recognition of the wide diversity of physician practices, we intend for the Quality Payment Program to allow physicians to pick their pace of participation for the first performance period that begins January 1, 2017," Acting Administrator Andy Slavitt wrote on the official CMS blog.
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Surgery Center Offers Same-Day Total Hip & Knee Replacement
KEZI-TV (Eugene, Ore.) (09/08/16) Lani, Angelica Lei

There's a new procedure at a Eugene surgery center that helps patients spend less time in the hospital and more time on their feet. The Renew Total Joint Replacement program is the first of its kind being offered at Slocum Surgery Center.
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2016's States With the Best & Worst Health Care
WalletHub (09/06/16) Bernardo, Richie

More Americans have access to health care today, but cost and quality vary widely from state to state. According to the Pew Charitable Trusts, state health costs depend on a number of factors, ranging from federal legislation to the overall health of residents to the number of "public charges" such as prisoners and recipients of social assistance.
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Cigna Can't Sign Up New Medicare Customers Due to U.S. Probe
Bloomberg (09/06/16) Tracer, Zachary

Health insurer Cigna Corp. won't be able to sign up new customers for its private Medicare plans during the fall enrollment season this year because of an investigation by U.S. regulators. The Centers for Medicare and Medicaid Services said in January that it found "widespread and systemic failures" in Cigna's private Medicare business.
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