ASCA News Digest (May 28, 2014)

News Digest


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May 28, 2014


ASCA Highlights

Industry News

  • Differentiate your ASC from the competition: 6 Ways for ASCs to Use Their EMR as a Marketing Tool.
  • ASCs nationwide are making the switch to the AmkaiCharts EMR and AmkaiOffice business management system. Let them tell you why!
  • "AmkaiCharts lets our nurses spend more quality time with patients, and spend the time more efficiently" – Tabitha Vaughn, St. Charles Surgery Center. Find out what AmkaiCharts can do for your ASC.
  • The Amkai GINote: Intuitive, efficient documentation with just one click at the point of care. Learn more!
  • Thank you to the many new AmkaiSolutions followers on Twitter and LinkedIn.

ASCA Highlights

Working With Compounding Pharmacies: What You Need to Know

Recent developments affecting compounding pharmacies are affecting the ways they can do business with your physicians and your ASC. Can your ASC work safely with a compounding pharmacy? Are there changes in the state and federal rules that apply? Register for ASCA's next webinar on Tuesday, June 3, at 1:00 pm ET to find out. MORE
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GO GREEN! SELL, TRADE OR UPGRADE YOUR MEDICAL EQUIPMENT! The Alternative Source Medical is a long standing, established vendor, and distributor of pre-owned, warrantied refurbished and new medical exam equipment. We also are a great resource to turn your decommissioned, unused medical equipment into cash. No fees! No contracts! Learn more at

Ensuring Patient Safety with CapnographyThe RespSense™ and LifeSense® capnography monitors are simple-to-use, cost-effective tools that help you ensure your patients are adequately ventilated during sedated dental procedures. The monitors provide continuous and reliable monitoring to help identify potentially life-threatening ventilation status changes such as respiratory depression during dental procedures on sedated patients.

The combined June-July 2014 issue of ASC Focus is now available online. Highlights of this month’s issue include how to cope when a leader leaves, laser safety, implementing a culture of safety and advice from an administrator who took the plunge with EHR. MORE
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Order the entire package of all of the ASCA 2014 session recordings on ASCA's Learning Center. If you could not make it to the meeting or if you were unable to sit in on every session that you wanted to attend, order session recordings to review all of the education content that the conference had to offer. MORE
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Planning has begun for ASCA 2015 to be held in Orlando, May 13–16, 2015. Your ideas for session topics and speakers are an invaluable part of determining the exceptional educational content that the meeting provides every year. Submissions for ASCA 2014 will be accepted through July 31, 2014. MORE
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If you attended ASCA 2014 in Nashville, you have until June 30, 2014, to submit your continuing education credits online. To submit online, you will need your ID number located on the back of your attendee badge. (If you no longer have your badge, you can request your ID number by sending an email to MORE
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Mark your calendar for ASCA 2015, May 13–16, 2015, at the Orlando World Center Marriott Resort & Convention Center in Orlando, Florida. The newly renovated hotel, located near Disney World, features a full-service boutique spa, an 18-hole championship golf course and two 200-foot water slides. MORE
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The House Energy and Commerce Health Subcommittee held a hearing yesterday to examine some of the issues surrounding payment disparities between hospitals, outpatient departments, ambulatory surgery centers and physician offices. MORE
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Industry News

Bundled Payment Experiment by Bedford Surgery Center
Nashua Telegraph (05/23/14) Brooks, David

A pilot program has been launched by Bedford Ambulatory Surgery Center in Bedford, N.H., and Harvard Pilgrim Health Care under which routine colonoscopies are covered by a fixed "bundled payment" determined in advance. The bundled payment is inclusive of fees and costs for surgeons, anesthesiologists, and other clinicians. The pilot program has been partly prompted by the Affordable Care Act and other initiatives that call for more transparency about costs. "We see it as a way to get everybody to have some skin in the game," says Harvard Pilgrim's William Brewster. He also hopes to develop a framework that enables all the parties to communicate and share patient records.
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What Should Providers Be Doing During the ICD-10 Waiting Game?
EHR Intelligence (05/19/2014) Bresnick, Jennifer

The Centers for Medicare & Medicaid Services has set Oct. 1, 2015, as the official date for ICD-10 compliance. The additional time gives providers an opportunity to incorporate dual coding into their plans, which may help organizations strengthen their existing billing programs, says Mel Tully at Nuance. "If you have a mediocre program in ICD-9, you'll have a mediocre program in ICD-10, so it's time to make those changes, hire appropriately, getting the right people in line," she advises. "And then, also make sure that you have the tools and the software so that the documentation specialists can actually start practicing and be successful." Providers also should make arrangements for end-to-end testing to facilitate the passage into ICD-10 in 2015.
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Should Medicare Pay the Same No Matter Where the Patient Gets Care?
Kaiser Health News (05/21/14)

Medicare currently pays different rates for the same services to patients based on where it was performed, such as in a hospital outpatient department, physician’s office, skilled nursing facility, or in-patient rehabilitation facility. Legislation proposed by Rep. Mike Rodgers (R-Mich.) seeks to make payments essentially the same for cancer services, while a bill from Rep. David McKinley (R-W.Va.) would require Medicare to pay a single rate for a particular condition after a patient leaves the hospital for post-acute care. Overhauling Medicare's physician payment formula is estimated to cost $150 billion, and one way to offset that cost is through site-neutral payments.
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Blog: Following Abuses, Medicare Tightens Reins on Its Drug Program
NPR Online (05/20/14) Gorenstein, Charles

On May 19, the Centers for Medicare and Medicaid Services finalized a rule that enables it to expel physicians from the Medicare program for abusive prescribing practices. Problem providers would be identified using prescribing data, disciplinary actions, and malpractice lawsuits, among other things. The rule also closes a loophole allowing some providers to operate with little or no oversight by compelling them to enroll in Medicare to order medications for patients covered by its Part D drug program. Providers have until June 1, 2015, to enroll in Medicare or formally opt out.
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Bundled Payments Could Cut Medicare Fraud, Experts Say
USA Today (05/19/14) Kennedy, Kelly

Health and policy experts say lump sum or "bundled" payments will save Medicare millions of dollars over current fee-for-service payments, while minimizing fraud and the over-use of medications. At a recent hearing on the nomination of Sylvia Mathews Burwell as secretary of the U.S. Department of Health and Human Services, U.S. Sen. Elizabeth Warren (D-Mass.) said a bundled payment demonstration project at Bay State Health in Massachusetts saved $2,000 per Medicare patient and could save the Medicare program around $46.6 billion over the next seven years if implemented nationally. Burwell indicated that she would try to expand such efforts. Among other bundled payment projects, the Centers for Medicare and Medicaid Services' Accountable Care Organization pilot program under the Affordable Care Act signed up 114 ACOs for the Medicare program and saved $380 million in 2013.
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Patients Lose When Doctors Can't Do Good Physical Exams
Kaiser Health News (05/20/14) Boodman, Sandra G.

As health care becomes more technology based, some doctors may not be using physical exams to make accurate diagnoses, warn medical educators. They say it is important for doctors to identify underlying diseases or emerging problems by doing such things as inspecting blood vessels at the back of the eye, observing a patient walk, feeling the liver, feeling lymph nodes, and checking fingernails. Some medical schools are launching programs to revive and teach physical diagnosis, also known as bedside medicine, including Stanford, Jefferson and Johns Hopkins. Steven McGee at the University of Washington says studies have found that physical exam findings can be as accurate as their technological counterparts, such as the presence of abnormal eye movements to distinguish a serious stroke from an inner ear problem more accurately than an initial MRI.
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States Stick to Insurance Exchange Models
Modern Healthcare (05/19/14) Dickson, Virgil

Although the first Obamacare enrollment period did not go smoothly, no states have asked the Obama Administration to assume control of their marketplaces, and none have decided to abandon to run their own. A spokesperson for the Centers for Medicare and Medicaid Services says the agency did not receive any requests by the May 1 deadline for states to switch models. Observers are surprised by the lack of response, especially given that Hawaii, Maryland, Massachusetts, and Oregon were expected to abandon their troubled exchanges. West Virginia, meanwhile, says it will maintain a model that gives it some say but does not require it to assume full responsibility, with State Insurance Commissioner Michael Riley noting, "It was determined early on, back in 2012, that it did not make fiscal sense to build, operate, and maintain a state exchange given West Virginia's small population."
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Roanoke Eye Surgery Center Gets Preliminary Approval
Roanoke Times (VA) (05/19/14) Hammack, Laurence

Regulators in Virginia have tentatively approved a planned eye surgery center in Roanoke. The application for the plan stated that a third operating room is required to accommodate growth at the Roanoke Valley Center for Sight, whose Salem location had a utilization rate of 118 percent last year, according to a staff report by the Virginia Department of Health. Letters of support for the new location praised the Center for Sight's track record in general and cited a rising need for ophthalmological surgery among the region's aging population. If a certificate of public need is granted, the Center for Sight intends to spend approximately $786,000 on the facility, which would aim to open by January 2016.
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Rex Wants to Switch Up Wakefield Surgery Model and Cut Costs in the Process
Triangle Business Journal (05/19/14) deBruyn, Jason

Rex Healthcare, a subsidiary of UNC Health Care, is looking to establish a new joint venture ambulatory surgery center (ASC) in Wakefield, N.C. Rex, which already operates two such models in Cary and Edwards Mill, hopes to recruit 20 to 30 surgeons for the venture. The company noted that while it is still in early talks, it plans to transform the existing operating room at its Wakefield campus to the ASC. Doing so would cost less than $500,000, Rex said.
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Monocacy Surgery Center Opens in Frederick
Frederick News-Post (MD) (05/14/14) Waters Jr., Ed

A new ambulatory surgery center has opened in Frederick, Md., to provide services in orthopedics, hand surgery, podiatry, otolaryngology, neurosurgery, and pain management. Monocacy Surgery Center LLC was formed by physicians in association with SurgCenter Development, an ambulatory surgery center development company. The physician-owned and -operated facility seeks to achieve the most successful outcomes for patients, including excellent patient satisfaction rates and near zero infection rates. Monocacy Surgery Center has been evaluated and approved by the Joint Commission to assure it is adhering to a high level of safety and compliance with nationally recognized standards of care.
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Hospital Deaths in Patients With Sepsis From 2 Independent Cohorts
Journal of the American Medical Association (05/18/14) Liu, Vincent; Escobar, Gabriel J.; Greene, John D.; et al.

Millions of patients globally are affected by sepsis, the inflammatory response to infection. Its effect on general hospital mortality has not been evaluated, prompting researchers to quantify the contribution of sepsis to mortality in two complementary groups of patients from Kaiser Permanente Northern California and the Health Care Cost and Utilization Project's Nationwide Inpatient Sample. The researchers found that patients with initially less severe sepsis represented the bulk of sepsis deaths. As a result, improving standardized care for patients with less severe sepsis could drive future reductions in hospital mortality, the researchers say.
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Longitudinal Assessment of Colonoscopy Quality Indicators: a Report From the Gastroenterology Practice Management Group
Gastrointestinal Endoscopy (05/14) Hernandez, L.V.; Deas, T.M.; Catalano, M.F.; et al.

A recent study sought to assess the variability of adenoma detection rates (ADRs) at ambulatory surgery centers for 370 gastroenterologists in the United States. The observational cross-sectional analysis, conducted from 2007 to 2012, used a database to measure the number of colonoscopies with an adenomatous polyp and divided that by the total number of colonoscopies. The researchers concluded that differences in performance among practice sites were relatively consistent over the study period. According to the authors, "The ability of certain sites to sustain their high-performance over 6 years suggests that further research is needed to identify key organizational processes and physician incentives that improve the quality of colonoscopy."
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