ASCA News Digest (November 25, 2014)


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November 25, 2014


ASCA Highlights

Industry News

ASCA Highlights

ASCA Payment Resources Updated with 2015 Final Rates

Resources to assist ASC operators in determining the impact of Medicare’s 2015 payment changes are now available on ASCA’s web site. These resources include ASCA’s Medicare Rate Calculator, a list of the procedures classified as office-based for 2015 and an updated list of device-intensive codes with payment rates. MORE

ASCA has partnered with HealthStream to offer a collection of 21 courses that apply specifically to ASCs and are designed to train ASC staff on the most current regulations and standards of care. 16 of the interactive courses provide continuing education (CE) credit. Reduced prices are available through January 31, 2015. MORE
98.9 percent of Medicare-certified ASCs successfully met requirements for the first full year of Medicare’s ASC Quality Reporting Program and will receive the full annual payment update for 2015, CMS announced last week. In 27 states and the District of Columbia, 100 percent of the ASCs required to participate successfully met the reporting requirements. MORE
Registration is now open for ASCA 2015, May 13–16, in Orlando, Florida. Register today to take advantage of early bird discounts. ASCA members can enjoy additional savings by sending more than one attendee. ASCA 2015 will offer more than 60 educational sessions and networking opportunities to exchange best practices and discuss marketplace trends that could have immediate and long-term implications for your ASC. MORE
While a recent report from the Pennsylvania Health Care Cost Containment Council (PHC4) contains some interesting data about Pennsylvania ASCs, it falls short of presenting an accurate profile of the real-life operating value that ASCs provide to their patients and the state of Pennsylvania. MORE
Do you or someone you know have an interest in helping to advise Congress on Medicare payment policy? ASCA is calling for nominations to the Medicare Payment Advisory Board (MedPAC), which is an independent congressional agency charged with advising Congress and the US Department of Health & Human Services (HHS) on Medicare payment policies, patient access and quality of care. MORE
CMS is hosting a free webinar regarding the 2015 final ASC payment rule and the requirements for the ASC Quality Reporting Program that will affect 2016 and subsequent years’ payment determination criteria. The webinar will take place Friday, December 5, and two sessions will be offered at 10:00 am and 2:00 pm ET. MORE
If you attended ASCA's 2014 Fall Seminar in Scottsdale, you have until this Sunday, November 30, 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
ASCA has begun reaching out to the more than 60 incoming members of Congress about the benefits of touring an ASC. The congressional turnover has created opportunities to build new relationships with members of Congress who may not be familiar with the high quality, cost effective care that ASCs provide patients in their state and districts. MORE
Due to the Thanksgiving holiday, there will not be a Government Affairs Update this Thursday, November 27. ASCA wishes everyone safe travels and a happy holiday.

Industry News

High-Deductible Insurance Plans Put Pressure on Independent Physicians to Collect Bills
Pittsburgh Post-Gazette (11/23/14) Twedt, Steve

The proliferation in low-premium, high-deductible health insurance plans is impacting small physician practices and ambulatory surgical centers. Donna Kell, CEO of Kell Group billing services, notices a trend over the past four years of patients who are unable to pay their deductible at the time they receive care. An annual employer survey by Mercer found that nearly half of larger employers now offer a high-deductible plan. Terry Bohlke, president of the Ambulatory Surgery Center Association, says high-deductible plans are "definitely a two-sided issue" for the group. He says ambulatory surgical centers likely will see more patients as consumers with high-deductible plans pay more attention to costs, but "collecting from individuals is that much more complex and risky than collecting from insurance companies." According to Bohlke, Kell, and others, providers work with patients who are struggling to pay for their care by accepting credit card payments or setting up payment plans.

End to Global Payments a "Nightmare," Surgeons Say
Health Leaders Media (11/12/2014) Clark, Cheryl

The American College of Surgeons (ACS) is criticizing a rule recently issued by the Centers for Medicare and Medicaid Services that calls for global surgical payments to be gradually phased out in favor of separate payments for individual procedures and services. ACS Medical Director Frank Opelka says the rule is overly burdensome for surgeons because it will be very difficult for them to keep track of all the different payments they receive for different services. The policy is expected to affect roughly 25 million procedures per year, an ACS analysis of statistics from 2013 suggests. In addition, it could result in lower payments to some surgeons, Opelka says. Patients could also be harmed by the move away from global surgical payments, as the new system could prompt some to pass on necessary health care procedures in the name of saving money. The new policy will be phased in beginning Jan. 1, 2017.

ICD-10 Coalition Urges Congress to Avoid Additional Delays
EHR Intelligence (11/19/2014) Bresnick, Jennifer

A coalition of health care groups has sent a letter to House and Senate leaders urging lawmakers to halt any further delays for migrating to the new ICD-10 diagnosis code set. The letter from the Coalition for ICD-10 cites the ongoing costs of revising ICD-10 transition projects and the need to implement the codes to ensure more accurate billing. A recent AHIMA report reduced the American Medical Association’s estimated cost of ICD-10 implementation for small physician practices from a high of $100,000 to approximately $5,000, but some organizations may need to extend educational programs or re-train coders. "HHS has estimated the cost of the most recent delay at $6.8 billion; further delays beyond October 1, 2015 range from $1 billion to $6.6 billion in additional costs," the letter states.

With Pay Stalled, Physicians Work to Advance Practices
PR Newswire (11/19/14)

Medical practices can take several steps to boost revenue, according to Physicians Practice's annual Physician Compensation Survey. For instance, practices can make sure everyone is working to the level of their license and utilize tech investments to generate valuable practice data. The survey of 1,338 physicians found that 33 percent of respondents said they have increased the number of patients seen per day, 29 percent said they have taken on additional work outside of the practice, and 23 percent say they have added ancillary services. Half of the respondents said in the next five years, they will continue practice operations as they do now, while 12 percent said they plan to retire or become employed by a larger health system. Thirty percent of the physicians surveyed said all of their compensation is linked to productivity, but 36 percent said this played no role in their pay.

Patient Use of Online Reviews
Software Advice (11/19/2014) Leslie, John

Patients are increasingly using online physician reviews to select doctors, according to a survey by Software Advice. The number of patients using online reviews increased 68 percent from 2013 to 2014, and 44 percent of respondents said they were willing to go out-of-network for a doctor with more favorable reviews. Yelp was the most popular online review site, tying with HealthGrades for most trusted. When physicians respond to any review, they should ensure patient anonymity in accordance with HIPAA rules. Software Advice says the majority of reviews are motivated by positive experiences, so physicians should focus on improved diagnostic accuracy and listening skills to increase the likelihood of positive reviews.

A Quarter of Uninsured Say They Can't Afford to Buy Coverage
Kaiser Health News (11/21/14) Carey, Mary Agnes

A survey released Nov. 21 by the Kaiser Family Foundation reveals that almost 25 percent of uninsured respondents will continue to lack coverage because they do not think they can afford it. Overall, 50 percent of respondents said they plan to obtain coverage, and 41 percent plan to remain uninsured. Of the 1,501 adults polled, 62 percent said it was very important to have health insurance, 24 percent said they had been hurt by the federal health law, 16 percent said the law has helped them, 47 percent view the law unfavorably, and 37 percent have a favorable opinion of the law.

KQED's #PriceCheck Project Shows Steep Variation in Prices Paid by Health Insurers (11/17/14) Aliferis, Lisa

Earlier this year, public media outlet KQED turned to crowdsourcing to shed light on health care prices. The company partnered with KPCC in Los Angeles and to launch a project called PriceCheck, which lets consumers share what they paid for common health care procedures. Hundreds of people responded with prices for the procedures, and thousands have since searched the database to help find dependable and accurate prices. Although PriceCheck requested prices in four areas--mammograms, lower-back MRIs, IUDs, and diabetes test strips--consumers also shared prices for other procedures. There were wide variations in terms of prices for the procedures in the database, some thousands of dollars apart. The researchers note that there were many questions about quality and price, but they believe "that driving cost transparency helps drive quality discussions, too."

2015 Ambulatory Care National Patient Safety Goals
Joint Commission Press Release (11/14/14)

The Joint Commission's latest National Patient Safety Goals for ambulatory organizations seek to tackle problems in health care safety and how to solve them. The initiative calls for using at least two ways to identify patients, such as the patient's name and date of birth, to ensure each patient receives the correct medicine and treatment. Extra care should be taken with patients requiring medicines to thin their blood. In addition, health care facilities are urged to use hand-hygiene guidelines from the Centers for Disease Control and Prevention or the World Health Organization. Also, to ensure the correct surgery is done on the correct patient, providers should mark the appropriate place on the patient's body where the surgery is to be done and pause before the surgery to make sure that a mistake is not being made.

Report: Activity at Local Outpatient Centers Remains Status Quo
Observer-Reporter (Pennsylvania) (11/19/2014) Bradwell, Michael

Last year saw the addition of four ambulatory surgery centers (ASCs) in Pennsylvania, according to the Pennsylvania Health Care Cost Containment Council. This means there are now 285 units in the state. The ASCs make up the majority of all Pennsylvania health care facilities, which include general acute-care hospitals and non-general acute-care hospitals. The ASCs reported 1.1 million outpatient visits and $1.2 billion in net outpatient revenue in the 2013 fiscal year. Statewide, the number of procedures performed at ASCs rose 0.5 percent in 2013.

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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.

Contact Us: Advertising inquiries should be addressed to Chris Schriever or Alex Yewdell at 202.337.1897 or at

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