ASCA News Digest (February 19, 2014)


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February 19, 2014


ASCA Highlights

Industry News

  •  Free White Paper: 10 reasons why ASCs nationwide are implementing an EMR.
  • "To get the maximum benefits, you need to switch to an EMR specifically designed for an ASC" - Anne Dean, The ADA Group. Learn why in this Q&A.
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  • "Growth of 23-Hour Stay Programs for Ambulatory Surgery Centers" - Read the article.
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ASCA Highlights

Staffing is one of the two largest variable expenses for surgery centers, and the cost of staffing increases significantly with staff turnover. Learn what you need to know about hiring, training and retaining personnel during ASCA's next webinar on Tuesday, February 25, at 1:00 pm ET. MORE
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Attend ASCA 2014, May 14–17 in Nashville, to join a physician from one of six different specialties and learn how they overcame challenges moving new procedures into the ASC setting. The featured specialties will be ophthalmology, gynecology, total joint, bariatric (sleeve) surgery, spine and urology. MORE
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Get the practical know-how you need to design and develop a simple and focused quality improvement program for your ASC during the session “Creating QI Studies 101,” on Thursday May 15 at 11:00 am. Alsie Fitzgerald, AAAHC, will help you address where to get ideas for quality improvement and help you identify key indicators for your facility type. MORE
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We're here for you. It's a simple concept, but how many partners answer your questions and help guide you in your quest to manage your revenue cycle? LaClaro is always here to answer questions, offer guidance, and make sure your team has the data it needs to make better decisions for your facility.
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The digital edition of the March issue of ASC Focus is now available. Read the latest issue to learn how to sell your ASC, changes in accreditation standards, penalties and liability risks under the new HIPAA update and identifying risk factors to protect your ASC. MORE
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ASCA members can subscribe to the 2014 survey for $299 (the nonmember rate is $999). Even if you previously subscribed to the 2013 survey, you will need to purchase a new subscription in order to participate in the 2014 survey. Register today. MORE
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ASCA’s Advancing Surgical Care site now features a dedicated webpage to the “ASCs: A Positive Trend in Health Care” report. The report outlines how ASCs provide quality care at significant cost savings; how the ASC health care model enhances safety, convenience and patient satisfaction; and why ASCs continue to lead innovation in outpatient surgical care. MORE
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The coalition argued that this measure does not speak to the quality of care provided in the ASC and asked that CMS work with industry representatives on alternative measures. The collation also questioned the practical application of the measure and raised concerns as to how ASCs should collect and report the required data. MORE
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Industry News

The Cost of Implementing ICD-10 for Physician Practices--Updating the 2008 Nachimson Advisors Study
American Medical Association (02/12/2014) Hartley, Carolyn; Nachimson, Stanley

Deploying the new ICD-10 procedural and diagnostic codes by Oct. 1 will be costlier than previously estimated in 2008, according to new research funded by the American Medical Association. Additionally, costs are expected to vary widely based on practice circumstances, likely ranging from $56,639 to $226,105 for small practices, $213,364 to $824,735 for medium-sized practices, and about $2 million to more than $8 million for large practices. "Practices fortunate enough to have no cost associated with a software upgrade, perhaps around one-third, will see their costs toward the lower end of our range," the authors concluded. Migrating to ICD-10 will be further complicated by how practices use the mandatory 2014 certified electronic health record technology, or CEHRT, to comply with meaningful-use requirements to receive payments from the EHR incentive program created by the Recovery Act.
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Nurse Anesthetist Salary Data Just Released by
PR Web (02/14/14)

The median salary for a nurse anesthetist in the United States is $154,390, with the highest 10 percent earning $187,199 and the lowest earning $105,810, according to new Nurse Anesthetist Salary Data. This depends on factors that include geographical location, the population of the area where the nurse anesthetist lives, their practice setting, and their level of experience, though often there is room for negotiation, says Elizabeth F. Hansen, editor for Some nurse anesthetists work independently, and others with an anesthesiologist. Part of the job involves conducting preoperative interviews, administering anesthesia, and providing post-anesthesia care after a surgery.
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FIU Partners With Miami Children's Hospital for Outpatient Center
South Florida Business Journal (02/14/14) Bandell, Brian

Florida International University's health practice will open an ambulatory care center on the school's main campus, in partnership with Miami Children's Hospital. The planned 36,000-square-foot facility will be dedicated to pediatric outpatient surgery, and it is expected to open January 2015. The center is intended to serve the needs of the community and increase access to surgical care, said Miami Children's Hospital President and CEO Dr. Narendra Kini.
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Apprehensive, Many Doctors Shift to Jobs With Salaries
New York Times (02/14/14) P. A14 Rosenthal, Elisabeth

Changes in health care arena are leading a growing number of physicians to move from private practices to salaried positions at hospitals. The American Medical Association reports that some 60 percent of family doctors and pediatricians, 50 percent of surgeons, and 25 percent of surgical subspecialists are now employees, rather than independent. The right combination of salaried front-line doctors and specialists in one facility can help provide cost-efficient and coordinated patient care, but some of the new salaried arrangements may lead to additional charges if, for example, "facility fees" are added or extra tests are ordered.
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State OKs URMC's Application for Brockport Surgery Center
Rochester Business Journal (02/13/14) Astor, Will

The University of Rochester Medical Center will soon be opening an ambulatory surgery center in Brockport, N.Y., after the state health department's Public Health and Health Planning Council voted to approve its application. A date for opening the center, which will be located at the Strong West urgent care facility, is still months away, as the building will need modifications. State officials are reviewing the modification plans, which would add to the surgery center's originally projected cost of $1.9 million. Work is expected to start on the project in April.
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Drug Shortages Continue to Vex Doctors
New York Times (02/11/14) P. A15 Tavernise, Sabrina

The Government Accountability Office (GAO) reports that the number of annual drug shortages--both new and continuing ones--increased nearly threefold between 2007 and 2012. The most common drug shortages are for generic versions of sterile injectable drugs, as factories that manufacture them are aging and prone to quality problems that lead to temporary closings of production lines or entire factories. The GAO report concluded that the U.S. Food and Drug Administration (FDA) was preventing more shortages now than in the past, but the total number of shortages has continued to grow. There were 456 drugs in short supply in 2012, up from 154 in 2007. FDA senior official Dr. Douglas C. Throckmorton told lawmakers on Feb. 10 that the number of new shortages was on the decline for the first time in 2012 and that 2013 data indicates a similar downward trend. Two-thirds of the production disruptions that led to shortages were caused by quality problems and efforts to fix them, he said.
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Surgery Center Coming to Area
WPSD-TV (KY) (02/11/14) Hibbs, Jason

Two groups on opposite sides of the Ohio River--Massac Memorial Hospital in Metropolis, Ill., and the Orthopedic Institute of Western Kentucky in Paducah, Ky.--hope to launch a new outpatient orthopedic and podiatric surgery center by the end of the year. The new venture will be located in Metropolis after receiving approval from the state of Illinois. Orthopedic Institute CEO Greg Thompson noted the advantages of being "able to go into a place, get your surgery, and then go home the same day." The new center will employ 25 people, including nurses, administrators, and office staff.
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For Many, Few Health-Plan Choices, High Premiums on Online Exchanges
Wall Street Journal (02/13/14) P. A1 Martin, Timothy W.; Weaver, Christopher

An assessment by The Wall Street Journal of 36 states reveals that Americans in poorer counties often have fewer health insurance choices via the online exchanges created by the federal health law, resulting in higher premiums. Consumers in 515 counties in 15 states were found to have only a single insurer selling coverage through the online marketplaces, according to the analysis. In more than 80 percent of these counties, the only insurer is a local Blue Cross & Blue Shield plan. People living in more affluent and populous counties have access to lower-priced choices than those living in counties with a single insurer.
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Enrollment in the Health Insurance Marketplace Increases by 53 Percent in January
HHS News Release (02/12/14)

The U.S. Health and Human Services Department (HHS) reports that nearly 3.3 million people enrolled in plans via state and federal insurance marketplaces by Feb. 1, 2014, reflecting a 53 percent increase in overall enrollment over the prior three-month reporting period. Enrollment of young adults aged 18 to 34 grew by 65 percent in January, from 489,460 at the end of December to 807,515 as of Feb. 1. All other age groups together grew by 55 percent. The report also shows that 81 percent of young adults selected Silver plans or higher. HHS Secretary Kathleen Sebelius urged Americans to continue to sign up for a private plan of their choice, noting that open enrollment ends on March 31.
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A Comparative Analysis of Readmission Rates After Outpatient Cosmetic Surgery
Aesthetic Surgery Journal (02/01/14) Vol. 34, No. 2, P. 317 Mioton, Lauren M.; Alghoul, Mohammed S.; Kim, John Y.S.

New research indicates that rates of unplanned readmission following outpatient cosmetic surgery are low, and they compare positively with those for other outpatient surgical procedures. Using data from the 2011 National Surgical Quality Improvement Program, researchers found that the five specialties with the highest number of outpatient surgical procedures were general, orthopedic, gynecologic, urologic, and otolaryngologic, which had unplanned readmission rates ranging from 1.21 percent to 3.73 percent. The five most common outpatient cosmetic surgery procedures and their associated readmission rates were reduction mammaplasty (1.30 percent), mastopexy (0.31 percent), liposuction (1.13 percent), abdominoplasty (1.78 percent), and breast augmentation (1.20 percent). Operating time, as measured in hours, was an independent predictor of readmission, the researchers noted.
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S. Florida's Anti-Infection Efforts Yielding Results in Hip, Knee Replacements
South Florida Sun-Sentinel (01/30/14) Brochu, Nicole

Hospitals in South Florida such as Boca Raton Regional and Cleveland Clinic instruct hip and knee replacement patients to take prophylactic steps prior to surgery. These include swabbing their nostrils a week to 10 days before the procedure to check for staph bacteria. Studies reveal that up to 85 percent of staph infections contracted after surgery are derived from patients' own bodies. Doctors also tell patients to bathe in a special antiseptic solution two days before surgery and to take an hour long class on what to expect from surgery, what medications they will need to take, how to prevent infection, and what to do upon discharge. Boca Raton Regional's Dr. Charles Posternack says the facility reported no infections from the 52 knee replacement surgeries performed in the last quarter of 2013, and only eight infections in all of 2012 from 233 knee replacements.
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