ASCA News Digest (April 1, 2014)


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April 1, 2014


ASCA Highlights

Industry News


ASCA Highlights

Final Week to Take Advantage of Registration Discounts for ASCA 2014

Early registration discounts for ASCA 2014, May 14–17 in Nashville, end this Friday, April 4. Register today. ASCA members can save more than $100 on the registration price and enjoy additional savings by sending more than one attendee (all registrations must be received at the same time, received from the same address and covered under one payment). MORE
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Faster payments. Lower costs.

With ASC Billing Services from SourceMedical, your facility receives payments faster—by an average of over 20 percent—and reduces internal costs. Find out why Modern Healthcare ranked SourceMedical among the largest revenue cycle management companies in 2013. Learn more at .
  Subscribe to ASCA Benchmarking 2014

ASCA Benchmarking--ASCA's online clinical and operational benchmarking program--produces valuable data about your ASC that you can compare with national performance statistics on clinical outcomes, staff indicators, billing performance and much more. Q1 reporting opens today. Subscriptions are still being accepted. Sign up here.

The data collection period for the first quarter (Q1) of the 2014 ASCA Benchmarking Program opens today. Subscribers will receive an email alerting them when they can begin to submit data. The collection period will close April 30. Some new features and enhancements for 2014 include a new Executive Summary section and Quarterly Trends Report, new and revised survey questions and improved help capabilities. Log in or subscribe today. MORE
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Learn about the benefits of accrediting your ASC, the steps you need to take to obtain accreditation and how to comply with the most challenging accreditation standards. Register now for ASCA's next webinar "Why Become Accredited and Tips for Success" on Tuesday, April 8, at 1:00 pm ET. ASCA members save $50 on all of ASCA’s webinars. MORE
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Banks play a significant role in the life of an ASC. Banks are often involved at the inception of a center through providing construction, equipment and working capital financing. Banks work closely with the management company and/or investor group to structure the appropriate financing so the center can comfortably handle its debt obligations while adhering to the bank's underwriting standards. MORE
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Network with your colleagues and visit more than 180 companies in the Exhibit Hall during the Welcome Reception on Wednesday and the Networking Reception on Thursday. You will also have the opportunity to experience Music City firsthand by exploring Nashville’s renowned Honky Tonk Row during Friday's Social Event. Book your hotel room today. MORE
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ASCA staff asked for greater transparency regarding the criteria used by CMS to determine which procedures are moved to the ASC payable list. CMS staff suggested that ASCA could help by providing strong clinical data to bolster their arguments for approval of procedures. Your input is needed: We want to be responsive to CMS’ request for strong clinical data. MORE
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Industry News

Why Generic Drug Costs Are Rising
Healio (03/26/2014) Hovanesian, John A.

Drug manufacturers raised their prices on many generic medications last year, including doxycycline and pravastatin, according to a survey by the National Community Pharmacists Association, though not every dose of every drug has been affected by this change. Generic drugs account for 80 percent of all medications dispensed in the United States, and increasing costs for generics particularly affect patients with high deductible insurance and the so-called Medicare "donut" hole. This coverage gap--where Medicare patients must pay out-of-pocket for drugs--requires patients to bear 47.5 percent of the cost of brand-name medications vs. 72 percent of the cost of generic medications. It still may be worthwhile to buy the brand name product because in the donut hole, the entire price (before the 47.5 percent discount) of a brand-name drug is credited toward the patient's out-of-pocket cost, enabling the patient to get out of that hole faster.
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If You Like Your Scam, You Can Keep It: the Attack on Out-of-Network Doctors
Illinois Review (03/24/2014) Smith, G. Keith

Insurance companies' in-network systems were originally intended to curb costs and steer patients to quality care, but they often do the opposite, writes Dr. G. Keith Smith, co-founder of The Surgery Center of Oklahoma, an outpatient surgery center in Oklahoma City. Smith notes that fewer high-quality physicians are remaining in these networks because these organizations slash their fees every year. Carriers have developed various penalties and separate "in" and "out" of network deductibles that make it difficult to go out of network. But things are changing. "Employer groups (self-funded plans) are carving out more and more medical services from carrier/PPO groups, and are directly contracting with facilities like ours," writes Smith. "As prices fall and quality soars, all patients will benefit, even those who are not beneficiaries of these employer plans."
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Despite Progress, Ongoing Efforts Needed to Combat Infections Impacting Hospital Patients
CDC News Release (03/26/14)

Two new reports from the Centers for Disease Control and Prevention (CDC) show that on any given day, about one in 25 U.S. patients has at least one infection contracted during the course of a hospital stay, contributing to approximately 721,800 infections in 2011. Roughly 75,000 patients with health care-associated infections died during their hospitalizations. The most frequently occurring health care-associated infections were pneumonia (22 percent), surgical-site infections (22 percent), gastrointestinal infections (17 percent), urinary tract infections (13 percent), and bloodstream infections (10 percent). "Although there has been some progress, today and every day, more than 200 Americans with health care-associated infections will die during their hospital stay," says CDC Director Tom Frieden. He stressed that clinicians must prevent infections through basic preventive efforts, such as regular hand hygiene, as outlined in standard infection control practices.
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Reaction to ICD-10 Delay Mixed Ahead of Senate Vote on 'Doc Fix'
iHealthBeat (03/28/14)

As the U.S. Senate prepared to vote on a bill to delay the ICD-10 compliance deadline to Oct. 1, 2015, reactions to the proposal within the health care community were mixed. The Centers for Medicare & Medicaid Services estimates that a one-year delay of ICD-10 could cost between $1 billion and $6.6 billion, according to a blog post by the American Health Information Management Association, which opposes the bill. Brian Patty, chief medical information officer at HealthEast Care System in St. Paul, Minn., says the decision could hurt hospitals' relationships with affiliated providers. But other health care providers welcome the proposed delay. Medical Group Management Association senior policy adviser Robert Tennant said that, "The most important thing, at least in my mind, is that the claims continue to get paid and patients are seen."
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HHS Releases Security Risk Assessment Tool to Help Providers With HIPAA Compliance
HHS News Release (03/28/14)

The U.S. Department of Health and Human Services has introduced a new security risk assessment (SRA) tool to help health care providers in small- to medium-sized offices conduct risk assessments of their organizations. The SRA tool is intended to help practices conduct risk assessments in an organized and detailed way at their own speed. The tool allows them to evaluate data security risks in their organizations under the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. The downloadable application also generates a report that can be provided to auditors. The application is available for downloading at
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72-Hour 'Outpatient' Stay?
Health News Florida (03/25/2014)

A proposed bill that passed Florida's House Health Care Appropriations Committee on March 24 would allow ambulatory surgery centers in the state to request a separate license to operate as "recovery care centers" and keep patients on site for up to 72 hours. Florida state Rep. Greg Steube says HB 7111 would allow young and otherwise healthy patients who require such surgeries as knee replacement to undergo them in an "outpatient" center rather than in a hospital. Federal payment rules prohibit Medicare or Medicaid patients from taking advantage of the recovery-care option, according to the Agency for Health Care Administration, so the service would be limited to privately insured patients.
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Top of the List: Largest Triad Outpatient Surgery Providers
Triad Business Journal (03/21/14) Covington, Owen

The Triad Business Journal has ranked the largest outpatient surgery providers in the Triad region of North Carolina. The top five providers on the list are Wake Forest Baptist Medical Center, Novant Health Forsyth Medical Center, Cone Health, Alamance Regional Medical Center, and Surgery Center of Greensboro. Hospitals in the state are changing how they use in-house operating rooms, and health systems are making investments to upgrade facilities to provide more services with new technologies. Growth in the past 10 years has been almost exclusively in outpatient procedures, while inpatient procedures declined. Novant Health Forsyth Medical Center, for example, saw outpatient surgery volumes increase from 4,129 to 11,379 between 2003 and 2013, while inpatient volumes fell from 11,379 to 10,905.
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2014 ASC Valuation Survey
HealthCare Appraisers (03/21/2014)

A new survey of more than 500 ambulatory surgery centers (ASCs) nationwide reveals that in 2013, many respondents were actively searching for potential acquisitions. Overall, 52 percent of respondents performed due diligence on one to 10 ASCs, while 44 percent did so for 11 or more acquisition opportunities. Respondents also revealed yearly inflation increases in such areas as commercial payor rates, medical supplies, implantable device costs, and ASC staff raises. In addition, 79 percent of the respondents said they prefer between six and 15 physician owners for a single-specialty ASC, while 63 percent of respondents prefer between 11 and 20 physician owners for a multi-specialty ASC. More than three-quarters of the respondents said their typical management fees range from 5 percent to 6 percent of net revenue, while 4 percent report typical management fees of 7 percent of net revenue.
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Medical Device Recalls Nearly Doubled in a Decade
Wall Street Journal (03/21/14) Burton, Thomas M.

A Food and Drug Administration (FDA) report released on March 21 shows that the number of medical device recalls nearly doubled between 2003 and 2012, rising from 604 to 1,190 during that time period. The report also found that the number of Class I recalls, in which there was a reasonable chance of death in patients who used the recalled products, increased from seven in 2003 to 57 by 2012. An FDA official noted that some of the recalls were the result of inspections by the agency, while others were prompted by a workshop in 2010 that resulted in increased reporting of flaws in X-ray machines and other imaging devices. Meanwhile, the medical device industry trade group AdvaMed said the increase was the result of the industry's proactive reporting of adverse events to the FDA.
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South Carolina Endoscopy Center Sets High Bar: 100 Percent Colorectal Cancer Prevention
Gastroenterology & Endoscopy News (03/14) Vol. 65, No. 3 Smith, Monica J.

The South Carolina Medical Endoscopy Center in Columbia, S.C., relies on standard colonoscopic equipment and strict adherence to its protocol to achieve an unprecedented reduction in colorectal cancer incidence and mortality. With a goal of 100 percent colorectal cancer prevention, the group's protocol includes contacting patients with bowel preparation instructions two days before the procedure and using a two-person endoscopy technique. This step has a technician pushing the endoscope and providing torque, while the endoscopist oversees the polyp search-and-removal process. Sufficient time is provided for careful examination of the colonic mucosa during both insertion and withdrawal, and polyps are removed in all cases. Additionally, all personnel in the room view the video monitor and take part in the examination.
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Obamacare Enrollment Heading to 7 Million at Deadline
Bloomberg Businessweek (03/31/14) Wayne, Alex

Open enrollment for the 36 states served by the federal health exchange closes March 31, and early returns indicate that the Obama Administration could reach its goal of 7 million enrollees. The final tally of insured individuals may not be released for weeks, given that it remains uncertain how many enrollees have actually paid their first premium and that those who began the enrollment process prior to the deadline will be given extra time to complete it. It also remains uncertain how many enrollees were previously insured.
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U.S. Announces Further Exemptions for Insurance Enrollment Deadline
New York Times (03/27/14) P. A20 Pear, Robert

On March 26, the Obama Administration expanded the list of individuals who can enroll in health insurance after the March 31 deadline. Legal immigrants, victims of domestic violence, and those who experienced technical problems in completing their applications are among those listed in the 10 types of special enrollment periods for people with "complex cases." Centers for Medicare and Medicaid spokeswoman Julie Bataille says, "Any consumer who comes in after April 1 will have to attest to the fact that they were in line and eligible to continue their enrollment." Consumers granted a special enrollment period generally will have 60 days to choose a plan, and those doing so by April 15 and paying their first premiums will be eligible for coverage beginning May 1.
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