ASCA News Digest (April 22, 2014)

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April 22, 2014


ASCA Highlights

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ASCA Highlights

HHS Confirms Billions of Dollars of Medicare Cost Savings Tied to ASCs

In a report released last week, the US Department of Health and Human Services (HHS) Office of the Inspector General (OIG) found that outpatient surgical procedures performed in ambulatory surgery centers have saved Medicare more than $1 billion in each of the last several years—and have the potential for even greater savings in the future. MORE
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The data collection period for the first quarter of 2014 (Q1) will close next Wednesday, April 30. Start submitting your data now. If you haven’t purchased your 2014 subscription yet, you still have time to sign up. Unlike last year, we will not be offering pro-rated pricing for subscribing after the first quarter’s data collection closes. Sign up today. MORE
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CMS has released its April addenda, which provides second quarter updates to the ASC payment system. ASCA’s payment resources, including the Medicare Rate Calculator, have been updated to incorporate the April addenda changes. MORE
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CMS posted another addendum to the ASC Quality Reporting (ASCQR) Specifications Manual. The most substantial changes reflect the delay of data collection for ASC-11 until January 1, 2015. MORE
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Hospira has issued a nationwide recall of seven lots of Propofol Injectable Emulsion and a voluntary recall of one lot of 1% Lidocaine HCI Injection. Health care professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program. MORE
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This week, members of Congress are back in their districts, and now is the time to ask them to cosponsor the ASC Quality & Access Act of 2013 (H.R. 2500 / S. 1137). As ASC reimbursement continues to slide, it is vital for you to tell your story to legislators in order to protect patient access to high-quality, cost-efficient care. MORE
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ASCA representatives met with the CMS payment policy staff last week to present spine procedures that can safely be moved from the hospital outpatient prospective payment system (OPPS) list to the ASC list. Three medical directors from CMS participated in the discussion. MORE
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Industry News

AMA: Physicians Generate $1.6 Trillion in Economic Activity, Support 10 Million Jobs
American Medical Association News Release (04/16/14)

Aside from their role in community health care, physicians also impact national and state economies. New research from the American Medical Association shows that patient-care physicians contributed $1.6 trillion in economic activity and supported 10 million U.S. jobs in 2012. The report measured the economic impact of physicians nationally and in each U.S. state and the District of Columbia based on economic output, jobs, wages and benefits, and tax revenues. Each physician supported an average of 13.84 jobs. Physicians also contributed to a total of $65.2 billion in local and state tax revenues. While spending on physician services grew more slowly between 2009 and 2012, accounting for only 16 percent of all U.S. health care dollars spent in 2012, every dollar applied to physician services supported another $1.62 in other business activity.
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Heartbleed: What Is the Effect on Health IT?
Fierce HealthIT (04/11/14) Bowman, Dan

The Heartbleed bug revealed last week affects a wide range of technology, from websites to routers, and many health care IT systems are likely being affected as well. Heartbleed is a bug in the OpenSSL encryption scheme that can allow attackers to read portions of a server's memory, potentially exposing health records, login credentials, and other information. Health IT developer Lauren Still says that several online electronic health record platforms are affected by the bug, as are some state health insurance exchanges. Boston-based health attorney David Harlow says that even those platforms that are not directly subject to Heartbleed are likely to feel its broader effects, as it may set back trust trust in health IT even as its role in health care expands. Harlow says that those platforms that are directly affected by the bug should work to put fixes in place as fast as possible, even if that means delaying comprehensive testing. In addition, health IT firms should proactively inform their customers about the bug and what steps they are taking to address it.
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CMS Finally Breaks Its Silence on ICD-10 Delay
Health Data Management (04/14) Slabodkin, Greg

The Centers for Medicare and Medicaid Services (CMS) has finally issued a statement on the ICD-10 delay. Although its website still gives the implementation deadline as October 2014, the agency said, "With enactment of the Protecting Access to Medicare Act of 2014, CMS is examining the implications of the ICD-10 provision and will provide guidance to providers and stakeholders soon." Before CMS can issue a new compliance date, however, it will need to reconcile the legislative process with its regulatory process.
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How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs?
RAND Corp. (04/09/14) Auerbach, David I.; Heaton, Paul; Brantley, Ian

A new report from the RAND Corp. investigates what effects the Patient Protection and Affordable Care Act (ACA) is likely to have on the cost of liability insurance, including medical malpractice coverage. The report concludes that the effects of the ACA are likely to be relatively small but highly contingent on state laws. In general, the report expects that the ACA will lead to slightly lower prices auto insurance and workers' compensation coverage and slightly higher prices for medical malpractice coverage by 2016. These changes will be driven by changing behaviors, lower Medicare rates, differences in state liability laws, and wider use of medical services. Other long-term effects of the ACA could include changes to tort law, emergence of new liability payment models, increased subrogation of liability awards, and greater population health.
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Four Years Into a Commercial ACO for CalPERS: Substantial Savings and Lessons Learned
Health Affairs Blog (04/17/14) Melnick, Glenn; Green, Lois

An accountable care organization (ACO) formed in 2010 by Blue Shield of California, the California Public Employees Retirement System (CalPERS), Hill Physicians Medical Group, and Dignity Health hospital systems is one of the largest commercial ACOs nationwide. Blue Shield of California's Kristen Miranda says the ACO is now focusing more on ambulatory care, such as by using the ACO as a standard for Blue Shield's hip and knee replacement centers. She also says the ACO has targeted hip, knee, bariatric, spine, and hysterectomy surgeries for evidence-based practice research. Dignity Health's Stephen Foerster adds that the ACO partners "have collaborated extensively to ensure that all surgeries appropriate for the outpatient setting are performed in the outpatient setting, regardless of the fact that the hospitals are capitated for outpatient surgery."
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Wisconsin Hospitals Association: Hospitals Urge Collaboration Among Stakeholders to Expand Health Care Price Transparency (04/17/14) Grasmick, Mary Kay

A new report from the Healthcare Financial Management Association (HFMA) recommends that physicians, hospitals, insurers, and employers collaborate to provide consumers with the necessary data to make informed health care decisions. A task force convened by HFMA said that health plans should be the key source of price information for their members, and that health care providers be the main source of price data for uninsured patients and patients who are seeking care from the provider on an out-of-network basis. In Wisconsin, the WHA Information Center provides online postings of prices for every hospital and hospital-based surgery center for inpatient services, outpatient surgical and diagnostic services, emergency and urgent care services, and other non-surgical services provided on an outpatient basis, including radiological procedures.
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Ambulatory Care Facilities: The Evolution of Healthcare
Medical Construction & Design (04/14) Dailey, David

As health care delivery methods evolve, ambulatory care facilities are taking on a larger role. These facilities--including surgery centers, cancer centers, imaging centers, neighborhood-focused community clinics, and medical office buildings--offer cost benefits to health care organizations, as building codes and infrastructure requirements are not as restrictive as acute-care hospitals. As a result, outpatient centers are more affordable to build and have lower overhead expenses. Advances in technology are helping to drive this change, as minimally invasive procedures enable a wider range of services that can be provided in an outpatient setting. In terms of design, cancer and surgery centers are designed to create workflow efficiencies while having a welcoming aesthetic image for the community. Author David Dailey notes, "With a greater emphasis on patient outcomes, well-planned, well-designed ambulatory care facilities will play an integral role in community health."
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IMS Health Study: Spending Growth Returns for U.S. Medicines
IMS Institute (04/15/2014)

The total amount spent on medications in the United States reached $329.2 billion in 2013, and overall use of health care services rose for the first time in three years. A new report from IMS Institute for Healthcare Informatics found that total spending on U.S. medicines increased 3.2 percent on a nominal basis, up from a 1 percent decline in 2012. The primary drivers of this growth are reduced impact of expired patents, rising prices, innovative medicines, and greater use of the health care system. The number of visits to physicians' offices, hospitalizations, and filled prescriptions all increased in 2013. Patients with insurance paid higher out-of-pocket expenses in deductibles and co-insurance in 2013.
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AGA Continues to Call for More Transparency at CMS
AGA Washington Insider (04/09/2014) Teixeira, Kathleen

The American Gastroenterological Association and its sister groups are turning to lawmakers to request greater transparency as the Centers for Medicare and Medicaid Services (CMS) makes decisions affecting physician practices and their patients. In November, reduction in upper gastrointestinal (GI) endoscopy services in the Medicare Physician Fee Schedule Final Rule were revealed, prompting GI and other groups to work with U.S. Rep. Bill Cassidy (R-La.). Cassidy has circulated a letter to CMS asking it to publish any changes to physician values in the proposed rule to allow physicians the opportunity to participate in the regulatory process and provide meaningful comments. The effort is being supported by other physician societies, including cardiology, neurology, rheumatology, neurological surgeons, spine specialists, and osteopaths.
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Obama Administration Won't Extend Health-Insurance Enrollment
Wall Street Journal (04/16/14) P. A4 Radnofsky, Louise

The extension for most people who were "in line" on on March 31 to finish their applications for private coverage under the Affordable Care Act expired at midnight on April 15. Centers for Medicare & Medicaid Services spokesman Aaron Albright confirmed that the enrollment period would not be extended any further. Some enrollment centers that had long lines on March 31 said the backlog had been cleared during the first two weeks of April. However, people with complex cases, such as persistent technical problems, and those who have a change in circumstances like a job loss or divorce can still qualify to sign up outside the standard open enrollment period.
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