ASCA News Digest (November 11, 2014)


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November 11, 2014


ASCA Highlights

Industry News

ASCA Highlights

Escape the Cold This Winter at ASCA's Coding Seminar in San Diego

Register for ASCA’s 2015 Winter Coding Seminar, January 22-24, 2015, in San Diego, California. This comprehensive program is a "must" when it comes to learning best coding practices that assure you receive the reimbursements you deserve. Register by December 22 to take advantage of early bird discounts and ensure that your ASC is prepared for 2015’s coding and billing changes. MORE

Register for ASCA's next webinar on December 2 to learn the new, revised and deleted CPT codes that will affect ASCs in 2015. The presentation will address applications and scenarios for reporting the new codes as well as reimbursement potentials. ASCA members save $50 and CEU and AEU credit is available. MORE
ASCA has been inundated with questions from members regarding enrollment, data collection and reporting on ASC-8: Influenza Vaccination Coverage among Healthcare Personnel. In response, we have published a frequently asked questions page on ASCA's web site. MORE
In today's changing environment, revenue cycle management is more sophisticated and challenging than ever before. Successful billing teams place special emphasis on streamlining their processes, implementing best practices and focusing on continuously educating their staff. They consistently raise the bar as they watch their bottom line grow. MORE
Plan now to attend ASCA’s Medical Director Leadership Seminar, May 16-17, 2015, in Orlando. This premier seminar will address high-level aspects of issues surrounding ASC management, expectations and responsibilities. Participants will come together to examine current challenges and selected clinical concepts in ambulatory surgery. Join with ASC medical directors and physician leaders from across the country for this exclusive opportunity. MORE
As previously announced, CMS released its final 2015 ASC payment rule. ASC payment rates will increase by 1.4 percent in 2015, while HOPDs will receive a 2.2 percent increase. In addition to the payment updates, other changes from the final rule include a comprehensive APC policy and an expansion of packaged codes. MORE

Industry News

Justices to Hear New Challenge to Health Law
New York Times (11/08/14) P. A1 Liptak, Adam; Abelson, Reed

On Nov. 7, the U.S. Supreme Court announced that it would hear a case challenging the Affordable Care Act, particularly the tax subsidies millions of Americans have received to help them afford the plans they purchased through the state and federal exchanges. The lawsuit argues that the subsidies have been given unfairly to individuals in the 36 states that opted not to operate their own exchanges, focusing on language in the law that limits subsidies to "an exchange established by the state." If the High Court agrees, people in states relying on the federal exchange would be ineligible for those subsidies, and observers worry that such a ruling would destabilize the insurance markets and doom the law. The case likely will be argued in February or March, with a decision issued in June.

8 Health Care Facilities in Texas, Florida, Wisconsin Join Price Transparency Movement
PRWeb (11/04/14)

Pricing Healthcare's Web site has added six endoscopy centers in the Dallas-Fort Worth market, an ambulatory surgery center (ASC) in Tampa-St. Petersburg, and both an ASC and imaging center in the greater Milwaukee area. Prices have been published for such procedures as colonoscopies, orthopedic surgeries, hernia repair, and various imaging procedures. Pricing Healthcare is an online marketplace for direct-pay health care that features hundreds of procedures for facilities across the Untied States. The company works with hospitals, surgery centers, and imaging centers to enable them to publicize affordable, direct-pay pricing for their procedures via dedicated, branded pages.

Consumers Now Able to Window-Shop for Insurance on
Washington Post (11/09/14) Goldstein, Amy

Consumers can now browse and compare their insurance options on in advance of the open enrollment period that starts on Nov. 15. A portion of the site was turned on early to allow consumers time to window shop for health plans. Centers for Medicare and Medicaid Services officials say the new part of website will allow consumers to compare plans without entering any personal information. For price estimates, consumers will be asked for their Zip code, how many people will be covered by a health plan, and their income.

How to Save Money on Health Care (11/14) Browne, Andrea N.

One way consumers can reduce their health care costs is by asking their physician about less expensive facilities. Physicians often work at multiple hospitals or outpatient surgery centers, and while their charge remains the same irrespective of location, the hospital's fees can vary by thousands of dollars. Outpatient surgery centers tend to be the least expensive option. For instance, the average cost nationwide for a common joint procedure in a hospital is $2,548 compared with $959 at an outpatient surgery center. It is important to make sure that a particular facility is part of the insurer's network, however.

How Much Is That MRI, Really? Massachusetts Shines a Light
NPR Online (11/05/14) Bebinger, Martha

Comparing the price and quality of U.S. health care services remains difficult, but a law enacted in October requires insurers in Massachusetts to make all their prices public in advance. In addition, the tools available online can calculate an individual's cost for a procedure, based on their plan. The growing number of people with high-deductible health plans, who often pay the full cost of an office visit or test, can benefit significantly from knowing the prices. Barbara Anthony, undersecretary for consumer affairs in Massachusetts, has launched an ad campaign that calls on patients to shop around and compare prices before making a major health care decision. Anthony notes that doctors and hospitals are using the online cost tools as well. "They're already saying, 'I don't want to be the highest priced provider on your website--I thought I was lower than my competitors.' That's exactly the kind of reaction we want to see," she says.

GIQuIC Colonoscopy Quality Registry Surpasses 1 Million Colonoscopy Cases
PR Newswire (11/05/14)

More than 1 million colonoscopy cases have been submitted to the GI Quality Improvement Consortium's (GIQuIC's) national registry of endoscopic procedures. GIQuIC, a joint initiative of the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy, seeks quality improvement and encourages benchmarking among endoscopists and endoscopy facilities. With more than 2,000 physicians taking part, the registry collects more than 80 clinically relevant data fields for colonoscopy and more than 10 quality measures are benchmarked. "Every additional user makes the registry more valuable for everyone else who uses it," said Dr. Irving Pike, president of the GIQuIC Board. "As the data accumulates, the potential value of GIQuIC, not only as a national benchmarking tool, but also as a research database, grows."

Increasing Disparities in the Age-Related Incidences of Colon and Rectal Cancers in the United States, 1975-2010
JAMA Surgery (11/05/2014) Bailey, Christina E.; Hu, Chung-Yuan; You, Y. Nancy; et al.

Although the incidence of colorectal cancer (CRC) has been declining overall in recent years, it has been increasing among young adults. Researchers recommend additional studies to determine the cause and identify possible strategies for prevention and early detection. Investigators examined data from 393,241 patients in the Surveillance, Epidemiology, and End Results CRC registry who were diagnosed with colon or rectal cancer from 1975 through 2010. The overall CRC incidence rate decreased by 0.92 percent over this time period, with a steady decline among patients age 50 or older and an increase among patients aged 20 to 34.

Tenet Ceo Trevor Fetter Sees Big Growth in Outpatient Centers
Dallas Morning News (11/04/14) Jacobson, Gary

Dallas-based Tenet Healthcare Corp. has tripled the number of its outpatient centers nationwide to 200 since 2009, and it plans to launch more. During a recent conference call, CEO Trevor Fetter outlined the company's strategy in the areas of urgent care centers, ambulatory surgery centers, imaging centers, and freestanding emergency departments. In 2010, Tenet allocated $400 million to buy or develop outpatient centers and expected to generate $70 million in incremental adjusted earnings before interest, taxes, depreciation, and amortization. However, the company said it has invested $306 million and generated $87 million in extra earnings, representing 25 percent more earnings with 25 percent less capital. Fetter noted that ambulatory surgical centers typically cost $5 million to $8 million to build and generate $5 million to $8 million in revenue, with margins of 30 percent to 35 percent. "The reason margins are so high is that you don't have all the overhead and cost of a 24-7 hospital," he said.

H.I.G. Capital's Portfolio Company Surgery Partners Completes Acquisition of Symbion Holdings Corporation
Business Wire (11/04/14)

Surgery Center Holdings Inc. has completed a $792 million acquisition of Symbion Holdings Corp., Crestview Partners' portfolio company. The combined business, the second-largest and fastest-growing independent ambulatory surgery center operator in the nation, is expected to generate more than $900 million in annual revenues. The combined company will operate facilities in 26 states to provide clinical services from more than 2,400 physicians to about 500,000 patients a year.

Ask the Right Questions on Patient Satisfaction Surveys
Physicians Practice (10/23/14) Sprey, Erica

Doctors should be aware of new regulations that cover the use of patient satisfaction surveys, says Meryl Luallin, a consultant who works for a company that helps physicians' practices develop strategies for assessing and improving patient satisfaction scores. Beginning in 2017, practices will be required to administer Consumer Assessment of Healthcare Providers and Systems-Clinician & Group Surveys to their patients and report the results to the Centers for Medicare and Medicaid Services. Recommendations for how practices can ensure they get the best scores possible on surveys can be summarized in the acronym CLEAR: connect, listen, explain, ask and reconnect. For the ask component of the strategy, doctors need to ask patients whether they have answered all of their questions regarding the care they provide.

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About ASCA

Mission: The Ambulatory Surgery Center Association (ASCA) is the national membership association that represents ambulatory surgery centers (ASCs) and provides advocacy and resources to assist ASCs in delivering high quality, cost-effective ambulatory surgery to all the patients they serve.

About Us: At ASCA, we are eager to help you become better acquainted with our nation's ASCs and the people who own and operate them. We are also eager to help you develop policies on ASC-related issues. If you have questions, please contact us. We'll put you in touch with the experts and, if you like, arrange for you to visit an ASC in your area.

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