ASCA News Digest (February 25, 2014)

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February 25, 2014


ASCA Highlights

Industry News

5 Most Popular Articles of 2013  

ASCA Highlights

Learn How to Optimize ICD-10 at ASCA 2014

Learn how to align your resources to sustain financial success and ensure compliance with ICD-10 at ASCA 2014, May 14–17 in Nashville. Lisa Rock, president, and Jessica Edmiston, vice president performance review of National Medical Billing Services, will provide final go-live transition strategies and tips for building quality assurance into your ICD-10 procedures. 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.

We simplify ASC management.

We simplify ASC management. SourceMedical is the leading provider of software and billing services for Ambulatory Surgery Centers and Specialty Hospitals nationwide. For nearly 30 years, SourceMedical has stood as the trusted brand for innovative applications, industry expertise and unsurpassed customer service. To learn more, visit

Stop throwing money into hiring and training business office personnel until you know exactly what kind of employee you need and are ready to fill your open position. Arthur Casey, senior vice president of Outpatient Healthcare Strategies, will provide key insights into successful interviewing and selecting and hiring new personnel and help you make certain that you get the right individual for the job. MORE
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Recent changes to the CMS Conditions for Coverage make it clear that if an ASC’s infection prevention program does not follow nationally recognized infection control guidelines the center must be cited. The changes also include stronger language requiring the surveyor to issue a citation if there is a training deficiency. MORE
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All of the steps in the process of selling an ASC are important, but actually preparing for the sale is one of the most overlooked. When potential buyers of your ASC believe that you are prepared and understand your business, they are more likely to take you seriously, believe what you are telling them and increase the purchase price and improve the terms they offer. MORE
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Whether we like it or not, social media has fundamentally altered the way we communicate and the way we do business. Attend ASCA 2014 and join Marcus Crider, partner of Waller Lansden Dortch & Davis, LLP, as he examines employment issues related to social networking, including how to minimize potential liability from improper social media use and avoiding National Labor Relations Board scrutiny. MORE
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FMQAI, the ASC Quality Reporting Program support contractor, has released cataract and endoscopy measure tools designed to assist with data collection for the new quality measures ASC-9, ASC-10, and ASC-11. FMQAI posted cataract and endoscopy data collection tools and instructional guidelines for use. MORE
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Industry News

Surgical Site Infection Study: AHRQ Study Shows Low Rates of Serious Infections Following Ambulatory Surgery
Agency for Healthcare Research and Quality (02/18/2014)

New research reveals that rates of serious surgical site infection (SSI) are low in hospital outpatient departments, but they are still a significant risk for patients and continued quality improvement efforts are needed. The study, published in the Journal of the American Medical Association and funded by the Agency for Healthcare Research and Quality, looked at nearly 285,000 ambulatory surgeries and found that about three out of every 1,000 patients who underwent an outpatient procedure developed an infection within 14 days that required hospitalization. The research involved general surgery, orthopedic, neurosurgical, gynecologic, and urologic procedures performed at hospital-owned ambulatory (outpatient) settings in eight states; no freestanding ambulatory surgery centers were included. The study authors suggest that more attention be paid to preventing and reducing SSIs soon after ambulatory surgery, writing that "earlier access to a clinician or member of the surgical team ... may help identify and treat these infections early and reduce overall morbidity."
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CMS Will Run Medicare Claims With ICD-10 Codes Through 'End-to-End' Testing
Modern Healthcare (02/19/14) Conn, Joseph

Starting on Oct. 1, ICD-10 billing codes must be used to report medical diagnoses and inpatient procedures. To ease the transition, the Centers for Medicare and Medicaid Services (CMS) will offer "end-to-end" testing of Medicare claims using the new codes. Participating providers and suppliers can submit test claims to CMS and receive remittance advice, the agency says. The testing will examine whether providers, claims clearinghouses, and other submitters can successfully send claims containing ICD-10 codes to the Medicare fee-for-service claim systems.
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Health Care Cyberthreat Report
SANS Institute (02/01/2014) Filkins, Barbara

Cybercriminals are actively trying to gain access to patient data and Internet-connected medical devices, warns a new report from Norse Corp. and the SANS Institute. A study of cyberthreats in the health sector between September 2012 and October 2013 found exploited medical devices, conferencing systems, Web servers, printers, and edge security technologies, with 49,917 unique malicious events, 723 unique malicious source IP addresses, and 375 U.S.-based compromised health care-related organizations. The report indicates that simple security flaws can contribute to compromises as well, such as the use of default administrative passwords. The report recommends that organizations identify all potential points of attacks in their organizations and follow best practices for how to best configure their systems and regularly monitor them.
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How to Bring the Price of Health Care Into the Open
Wall Street Journal (02/24/14) P. R1 Beck, Melinda

In an effort to increase price transparency, health care plans are offering online tools that enable members to estimate their out-of-pocket costs. A startup called Healthcare Bluebook, meanwhile, assesses the negotiated rates paid for thousands of medical services in every ZIP Code and posts what it believes to be a "fair" price. Bluebook's founder and CEO Jeffrey Rice says the rates insurers pay for services can vary as much as chargemaster prices do. A few states have prohibited gag clauses in health-care contracts, and 16 states have "all-payer claims databases" intended to gather insurance claims data and use it to monitor trends and identify high- and low-price providers.
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Experts Identify Infection Prevention Trouble Spots in ASCs, Offer Advice for Compliance
Infection Control Today (02/16/14) Lillis, Karin

Infection control regulations required by the Centers for Medicare & Medicaid Services (CMS) for ambulatory surgery centers' (ASCs) participation in Medicare may cause some confusion among infection preventionists. "Ambulatory surgery centers want to do the right thing, but unfortunately the requirements aren't always clear," says Mary Post, RN, MS, CNS, CIC, infection prevention specialist with the Oregon Patient Safety Commission. Libby Chinnes, an infection control consultant, says that safe injection practices and environmental cleaning are two key areas of confusion. To help stay compliant with CMS regulations, Post and Chinnes suggest that ASCs look to organizations such as the Centers for Disease Control and Prevention or the Association of periOperative Registered Nurses for guidelines, have one person manage an ASC's infection prevention and control plan, be well-versed in the CMS standards, have infection prevention and survey readiness materials easily accessible, and provide training to both staff and surgeons.
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CMS Calls for Medicare Advantage Payment Cut
HealthLeaders Media (02/22/14) Cheney, Christopher

The Centers for Medicare & Medicaid Services (CMS) has proposed a 3.55 percent cut to Medicare Advantage (MA) for 2015, even though the MA program underwent a 6 percent cut in 2014. A February 14 letter to CMS signed by 40 U.S. senators urges the agency to maintain the existing payment rate level in 2015. "Studies show that enrollees in the MA program enjoy better health outcomes and receive higher quality care than their counterparts in the Medicare fee-for-service program," the letter states. CMS anticipates setting the final rate level for 2015 in early April.
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New Billing Standards to Help Patients With Debt
Associated Press (02/20/14) Johnson, Linda A.

Following a major illness or injury, it is essential for patients to discuss medical costs and payment options early on with their hospital or medical provider, which should include any available discounts and financial assistance. On Jan 15, new industry guidelines for resolving disputes about medical debt were unveiled to help financially struggling patients. Joe Fifer, president and CEO of the Financial Management Association, which helped develop the guidelines, says recommended standards include making bills easy to understand, ensuring hospitals and collection agencies are not sending a patient bills at the same time, and notifying credit agencies when a billing dispute is resolved. The Internal Revenue Service is expected to soon issue regulations that would prohibit nonprofit hospitals from charging uninsured patients more than the discounted rates for insured patients.
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U.S. Health Insurers Brace for New Steep Medicare Cuts
Reuters (02/20/14) Humer, Caroline

The federal government is expected to soon announce proposed payment rates for insurer-run Medicare plans in 2015. Industry officials predict the cuts could lead to higher co-pays and fewer benefits for seniors. Of the more than 50 million older Americans who receive coverage through Medicare, approximately 15 million are enrolled in Medicare Advantage plans offered by companies like UnitedHealth Group and Aetna. The remainder use Medicare fee-for-service programs under which doctors are reimbursed by the government for patient visits and procedures. A planned cut of roughly 6 percent to 7 percent is expected, according to the latest industry and analyst forecasts.
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CMS Releases PQRS Deadline Tracking Tool
EHR Intelligence (02/13/2014) Freeman, Nicole

Eligible professionals and group practices participating in the Centers for Medicare and Medicaid Services' Physician Quality Reporting System (PQRS) can use a new interactive tool from the agency that will help them stay on top of PQRS deadlines. The first set of deadlines that the tool will remind eligible professionals and group practices about takes place on February 28. By March 21, group practices will have to submit 2013 data through the Group Practice Reporting Option Web Interface. March 31 is the last day to submit 2013 PQRS data through the registry reporting method, as well as the last day for Maintenance of Certification Program entities to send in 2013 quality data. Reporting for the 2014 PQRS program year is scheduled to end on December 31 for both group practices and individuals.
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Public Health Threat Continues Despite Efforts to Help Ensure Product Availability
U.S. Government Accountability Office (02/10/14)

Drug shortages in the United States have been on the rise since 2007. Many shortages are of generic sterile injectable drugs, forcing providers to ration care or rely on less effective drugs, say provider association groups. Drug shortages can be attributed to manufacturers' quality problems or low profit margins of generic sterile injectables. Ideally, says the Government Accountability Office, the Food and Drug Administration (FDA) should improve its information systems to identify risk factors for potential shortages early enough to resolve them. The FDA also needs to develop policies and procedures to ensure staff enter information into the database in a consistent manner and enhance the accuracy of the information.
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Retrofitting Hospitals for Obese Patients
Modern Healthcare (02/08/14) Rice, Sabriya

Experts say hospitals need to make architectural and equipment changes to safely and effectively serve morbidly obese patients, as their numbers are on the rise. More hospitals are considering improvements to serve these patients, from installing wider CT scanners, wheelchairs, and blood pressure cuffs to redesigning their architecture to accommodate wider door frames. These changes not only improve the safety and comfort of patients but also the safety of hospital staff. "From an economic perspective, when we mismanage large patients, it's costly in terms of increased lengths of stay, injuries related to mobility issues--like falls or the development of pressure ulcers--and higher 30-day readmission rates," says Susan Gallagher Camden, a healthcare risk management expert.
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Orthopedic Associates Will Open New Surgery Center in Honolulu
Pacific Business News (02/13/14) Blakely, Jenna

Orthopedic Associates in Honolulu is opening a 9,200-square-foot surgery center called Minimally Invasive Surgery Hawaii. The new facility is housed on a different floor within the same medical office building now used by Orthopedic Associates, whose seven physicians will also run the new center, according to Administrator Kea Kometani. "At the facility, we will be doing outpatient procedures, things like shoulder surgery, knee surgery," Kometani says. "We also have three hand doctors on staff who can do carpal tunnel-related surgeries." The new surgery center has three operating rooms and is currently recruiting nurses and surgical technicians.
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Minimally Invasive Surgery Facility Opens at CMH
Register Star (NY) (02/16/14) Clayton, Adam

A new minimally invasive surgery center has opened in Hudson, N.Y., by Columbia Memorial Hospital's women’s health center. Dr. Edward Marici at Columbia Memorial Hospital was instrumental in launching the new center. "We saw a need in the community and wanted to fill that need," he says. The new facility specializes in the treatment of urinary stress, incontinence, overactive bladder, endometrial ablation, rectal incontinence, pelvic organ prolapse surgery, and cancer screenings. It also offers the laparoscopic removal of fibroids, treating endometriosis, and lysis of adhesions. Marici says it took roughly three years to open the center in order to achieve the necessary level of training and cross-departmental communication. "We now have a comprehensive gynecologic surgery center that focuses on pelvic conditions," he says. "And we are poised to continue bringing new technology and procedures to the twin-county area."
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