ASCA News Digest (March 4, 2014)

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March 4, 2014


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ASCA Highlights

Only One Month Until Q1 Opens for 2014 ASCA Benchmarking Survey

The data collection period for the first quarter (Q1) of the 2014 ASCA Benchmarking survey will open on April 1. 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. MORE
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5 Most Popular Articles of 2013  

Changing from a manual, paper-based system to an electronic solution for the pre-admission process can seem like a scary proposition for an ASC. But when executed effectively, the transition can yield significant benefits to a surgery center and its patients. MORE
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Attend ASCA 2014, May 14-17 in Nashville, and examine the steps you need to take to manage a comprehensive credentialing program, from the initial application process through board approval of your allied health professionals and physicians. MORE
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All four ASC accrediting bodies—the American Association for Accreditation of Ambulatory Surgery Facilities (AAASF), the Accreditation Association for Ambulatory Health Care (AAAHC), the Healthcare Facilities Accreditation Program (HFACP) and The Joint Commission—have made changes to their standards effective this year. MORE
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Renewal notices for 2014 have been mailed to all current ASCA members. We encourage you to renew your 2014 ASCA membership online and thank you for your continued support. Your membership helps ASCA provide the advocacy efforts and other resources that you and your ASC need to continue to operate and grow. MORE
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As part of its new eHealth University web site, CMS is offering several resources to help health care providers prepare for the October 1, 2014, ICD-10 compliance deadline. Resources include an introduction to ICD-10 fact sheet and transition checklists that outline tasks and estimated timeframes for important ICD-10 transition activities. MORE
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CMS Administrator Marilyn Tavenner confirmed that the October 1, 2014, ICD-10 deadline will not change. Tavenner said that the ICD-10 deadline has been delayed too many times and that the transition will occur on October 1, no matter what. MORE
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Industry News

ICD-10 Deadline Won't Be Delayed, Tavenner Tells HIMSS
Modern Healthcare (02/27/14) Conn, Joseph

The Centers for Medicare & Medicaid Services (CMS) will not delay the October 1 compliance deadline for the nationwide conversion to the ICD-10 family of diagnostic and procedural codes. Speaking at the Healthcare Information and Management Systems Society convention in Orlando, CMS head Marilynn Tavenner said, "There are no more delays and the system will go live on Oct. 1. Let's face it guys, we've delayed this several times and it's time to move on." Tavenner did say, however, that some exemptions will be made for providers who are having difficulty meeting their Stage 2 meaningful-use targets. She also said there will be no delay for Stage 2 compliance dates. American Medical Association president Dr. Ardis Dee Hoven expressed concern that "Medicare does not have a back-up plan if last-minute testing demonstrates anticipated problems with this massive coding transition," adding that "at the end of the day, sticking hard and fast to the ICD-10 deadline without a back-up plan to address disruptions in medical claims processing will hurt doctors and their patients."
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Fidelity: Doctors Need to Do More to Achieve 'Retirement Readiness'
Boston Globe (02/27/14) Reidy, Chris

A new report from Fidelity Investments of 5,100 physicians suggests that many are not saving as much for retirement as they should. A key reason is that many physicians are in their 30s by the time they graduate from school and start earning money, and they are often hampered by debt from student loans. Based on an assessment of retirement savings behaviors, many doctors are likely to replace only 56 percent of their income in retirement, according to Fidelity. The study says this is much lower than the income replacement rate of 71 percent that Fidelity suggests for those earning more than $120,000 annually. Doctors on average earn just under $300,000, the study says.
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Hospitals Coping Better as Drug Shortages Persist
Associated Press (02/28/14) Johnson, Linda A.

U.S. hospitals face exorbitant costs when obtaining medicines from alternate sources amid ongoing drug shortages, says a new survey by hospital group Premier Inc. The survey conservatively estimates that cost at $230 million annually for the country's 5,000 hospitals, on average, from 2011 through 2013. Shortages of drugs--in particular, low-cost, generic injectable drugs--have been on the rise since 2005, and affect hospitals, outpatient surgery centers, and cancer clinics. These shortages involve antibiotics, painkillers, anesthesia, sedatives, chemotherapy drugs, and heart drugs. Health care facilities are taking such steps as adding backup inventory, rationing certain scarce drugs, and implementing safety measures for alternative medicine choices.
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Departments of Justice and Health and Human Services Announce Record-Breaking Recoveries Resulting From Joint Efforts to Combat Health Care Fraud
Department of Health and Human Services (02/26/14)

The Departments of Justice and Health and Human Services recovered more than $4 billion from joint efforts to combat health care fraud in 2013. The annual Health Care Fraud and Abuse Control Program report notes that for every dollar spent on health care-related fraud and abuse investigations through this and other programs in the last three years, the government recovered more than $8. "With these extraordinary recoveries, and the record-high rate of return on investment we've achieved on our comprehensive health care fraud enforcement efforts, we're sending a strong message to those who would take advantage of their fellow citizens, target vulnerable populations, and commit fraud on federal health care programs," said Attorney General Eric Holder said. The joint anti-fraud effort between the two agencies has recovered $19.2 billion over the past four years.
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Health Plans Rush to Size Up New Clients
Wall Street Journal (02/28/14) P. A1 Mathews, Anna Wilde

Insurers are hurrying to collect health data from their newly acquired customers on public marketplaces. Such information as health status, prescriptions, and even personal habits will help insurers determine how much to charge next year, and whether they want to continue offering plans under Obamacare. Insurers are using online forms known as health-risk assessments in addition to making phone calls, sending emails, and writing letters to new enrollees. Blue Cross & Blue Shield of North Carolina is offering $50 gift cards to enrollees who fill out the assessments. Insurers that want to continue selling coverage on the marketplaces next year must submit their 2015 rates and other plan details to regulators this spring.
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Contamination of Stethoscopes and Physicians' Hands After a Physical Examination
Mayo Clinic Proceedings (03/14) Vol. 89, No. 3, P. 291 Longtin,Yves; Schneider, Alexis; Tschopp, Clément; et al.

Physicians' stethoscopes appear to play a role in bacterial transmission in hospitals, according to a study by researchers at the University of Geneva Hospitals. The study measured the level of bacterial contamination on physicians' hands and stethoscopes following a single physical examination. A total of 71 patients were examined by one of three physicians using sterile gloves and a sterile stethoscope. The stethoscope's diaphragm was found to be more contaminated than all regions of the physician's hand except for the fingertips. Similar results were observed when contamination was due to methicillin-resistant Staphylococcus aureus (MRSA) after examining MRSA-colonized patients.
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New Law's Demands on Doctors Have Many Seeking a Network
The New York Times (03/03/14) P. A1 Goodnough, Abby

Some self-employed primary care physicians are concerned how the federal health law will affect them as they deal with rising overhead, flat or falling reimbursement rates, and new rules. Some private practices are forming accountable care organizations, or networks of physicians that coordinate care for a group of patients, and are poised to gain financial rewards if they improve patients' health at a lower cost. According to the American Medical Association, only about 40 percent of family doctors and pediatricians remain independent. Those who are employed by hospital systems are finding advantages in the insurance negotiations these systems conduct on their behalf, reduced costs associated with overhead and malpractice insurance and, often, longer vacation times.
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Obama: Health Insurance Enrollment at 4 Million
Associated Press (02/26/14) Superville, Darlene; Thomas, Ken

On Feb. 25, President Barack Obama announced that around 4 million people have enrolled in health coverage through the federal or state marketplaces and urged millions more to enroll before the March 31 deadline. The White House's unofficial goal is to have 7 million people signed up for health insurance by the deadline. The president noted that millions of other Americans are benefiting from Medicaid expansion and staying on parents' health plans until age 26.
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WCIRB and CWCI Release Joint Ambulatory Surgical Center Study
Workers' Compensation Insurance Rating Bureau of California (02/26/2014)

Ambulatory surgery centers (ASCs) in California saw facility fee payments drop 26 percent per episode, on average, and 28 percent per procedure following fee schedule changes mandated by SB 863 in 2013, according to a new study by the Workers' Compensation Insurance Rating Bureau of California and the California Workers' Compensation Institute. The study measured average amounts billed and paid for workers' compensation outpatient surgery services rendered in the year preceding the adoption of the revised fee schedule (2012) and in the first six months following the effective date of revised fee schedule (January through June of 2013). The report also found there was no change in the mix of services or the percentage of episodes occurring in outpatient hospital settings and ASCs.
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Operating Room Equipment Market--Forecasts to 2019
PR Newswire (02/21/14)

The market for operating room (OR) equipment to 2019 will expand significantly in certain areas, such as specialty surgery tables and OR integration systems, according to a new report by Research and Markets. A predicted worldwide increase in the number of ambulatory surgical centers (ASCs) is expected to be a key factor affecting the market. The U.S. Medicare Payment Advisory Commission says that during 2006 to 2010, the number of Medicare-certified ASCs increased by an average annual rate of 3.6 percent in the country, and this steady increase in the number of ASCs is likely to contribute to the rising demand for various kinds of OR equipment. In addition, the report said, hybrid ORs provide surgeons and other health care professionals with better access to equipment as a result of integration of surgical function with imaging modalities.
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Standards Compliance Analysis Shows Where Ambulatory Organizations Excel and Where They Struggle
Infection Control Today (02/20/14)

A new report from the Accreditation Association for Ambulatory Health Care (AAAHC) says that ambulatory organizations received high marks for respecting and involving patients in health care decisions and for cost-controlling measures, such as administrative efficiencies and relevancy of treatments. The report, from AAAHC's Institute for Quality Improvement, also points outs areas that need continued attention, such as the appropriate documentation of patient allergies, practice privileges for health care professionals, and adequate internal emergency and disaster preparedness planning. AAAHC's AENEID (Accreditation Association Electronic National Evaluation and Information Dataset) initiative, for example, requires accredited organizations to conduct at least one drill each calendar quarter of the internal emergency and disaster preparedness plan.
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State of Infection Prevention in U.S. Hospitals Enrolled in the National Health and Safety Network
American Journal of Infection Control (02/01/2014) Vol. 42, No. 2, P. 94 Stone, Patricia W.; Pogorzelska-Maziarz, Monika; Herzig, Carolyn T.A.; et al.

Among hospitals enrolled in the National Healthcare Safety Network, variations were found in the presence of infection control and prevention policies as well as in clinician compliance with these policies, a new study reveals. Researchers looked at infection control efforts at more than 1,600 intensive care units in 975 hospitals and found there was an average of 1.2 infection preventionists (IP) per 100 beds. In addition, certification of IP staff varied between institutions and, in general, the average hours per week spent on data management and secretarial support were low. The researchers suggest that guidelines for IP staffing in acute care hospitals need to be revised.
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Relationship Between Patient Reported Experience (PREMs) and Patient Reported Outcomes (PROMs) in Elective Surgery
BMJ Quality and Safety (02/07/2014) Black, Nick; Varaganum, Mira; Hutchings, Andrew

A patient's communication with and trust in his or her doctor is associated with better effectiveness and safety in elective surgery. Researchers found a positive association between the patient's experience and the surgery's effectiveness when they looked at questionnaires completed by 4,089 patients who underwent hip replacements, 4,501 who underwent knee replacements, and 1,793 who underwent groin hernia repairs. Patients who rated their experiences more highly were less likely to report complications.
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