ASCA News Digest (January 10, 2017)

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January 10, 2017


ASCA Highlights

Industry News

Affiliate News   Affiliate News

    ASCA Highlights

    Learn How to Comply With Updated Life Safety Code Requirements

    Attend ASCA's next webinar Implications of the CMS Adoption of the 2012 National Fire Protection Association Life Safety Code to learn about how the Centers for Medicare & Medicaid Services’ decision to adopt the facility and life safety code requirements in the 2012 editions of National Fire Protection Association 99 & 101 has dramatically changed requirements for existing and new ASCs. ASCA will offer this webinar on Tuesday, January 24, at 1:00 pm ET.

    Note:Gain access to the entire 2017 webinar series, both the live events and recordings, at one low price with the All-Access Pass!
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    Get your members of Congress on your ASC’s side by participating in National Advocacy Day events this May in Washington, DC. ASCA will offer this opportunity in conjunction with its annual meeting, ASCA 2017, in Washington, DC, May 3–6. Registration for National Advocacy Day events for all ASCA members is included as part of registration for ASCA 2017.

    Speak face-to-face with your elected officials and members of their staff on one of two dates: Wednesday, May 3 or Thursday, May 4. This is your chance to educate your representatives in Washington, DC, about the issues that matter to your facility and the ASC community and to have a real impact on the decisions your members of Congress make.
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    The next Certified Administrator Surgery Center (CASC) exam period is March 1-31. If you plan to take the test, you must submit your application before the end of January. To access the exam application form and learn more about the CASC certification process, download the Candidate Handbook.
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    Purchase a subscription to the 2016 ASCA benchmarking survey, submit your ASC's Q4 2016 data between January 1–31 and review the findings for all ASCs from the full year in mid-February.

    ASCA Benchmarking is a national online clinical and operational benchmarking program that produces valuable data about your ASC. It allows you to compare your ASC’s numbers with national performance statistics on billing, staffing and outcomes.
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    The Centers for Medicare & Medicaid Services (CMS) recently released a correction notice that impacts the 2017 ASC final payment rates. These rates were effective as of January 1, 2017. ASCA has updated its 2017 Final Rate Calculator to reflect these changes.

    In addition to changes due to the correction, in response to ASCA member feedback we have also made sure that all codes, regardless of whether or not they are impacted by wage index, are now included in the rate calculator. For codes that are not impacted by wage index, only a national rate will show. In addition, there is now a column on the worksheet that indicates whether or not the code is subject to a geographic adjustment.

    The correction notice is available here. If you have any questions, please contact
    Kara Newbury.
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    The Coverage Your Patients Have—That You Don’t Know About

    Date: Tuesday, January 19th

    Time: 1:00-2:00 pm ET

    Unpaid self-pay balances continue to be a leading source of bad-debt and elevated days in AR for providers, from small providers to the largest health systems. In fact, bad debt in healthcare is projected to rise to $200 Billion by 20191. The good news? There’s active, billable coverage hiding in your “self-pay” accounts.

    Join us to learn how ZirMed Coverage Detection identifies and verifies active insurance coverage that wasn’t known at the time of service—including retroactive coverage your patients may be eligible for—and delivers the information you need to accurately bill payers for the care provided.

    In addition to diving into the state of the industry and the drivers behind hidden and unknown coverage, we’ll detail:

    • Why it costs, on average, twice as much to collect from patients than from payers.
    • How ZirMed Coverage Detection finds 2.8x more billable coverage than competitors’ applications—and delivers, on average, a 10% hit rate.
    • How Coverage Detection helps you enhance patient satisfaction by providing insight into the coverage your patients have or are eligible for.

    Industry News

    UnitedHealth's Optum to Acquire Surgical Care Affiliates for $2.3 Billion
    MarketWatch (01/09/17) Mathews, Anna Wilde

    UnitedHealth Group Inc.'s Optum health-services arm has agreed to acquire Surgical Care Affiliates Inc. for about $2.3 billion, adding a major surgical company to its growing roster of doctor groups and clinics. The deal, for a mixture of cash and stock, substantially expands the health-care provider footprint of UnitedHealth, which is already the parent of the biggest U.S. health insurer, UnitedHealthcare.

    One Medical Passport
    Cataract Surgery in Seniors Is Actually Life-Extending, New Study Says (01/06/17) Arvedlund, Erin

    New research suggests that if you undergo cataract surgery, you'll not only see more clearly, you also may actually live longer. A National Bureau of Economic Research study says Americans over 65 are living longer and with fewer disabilities, and that a chief reason is cataract surgery, which prevents falls and allows seniors to continue working and driving safely.

    Are Your Healthcare Prices Outrageous? Here's What Happens When Prices Come Out Of The Dark
    Forbes (01/06/17) Ubel, Peter

    They both had shoulder pain, persistent despite weeks of physical therapy. Both received MRI examinations at reputable radiology facilities, looking for things like rotator cuff tears, labral disruptions and other anatomical abnormalities.

    Investigators Link Anthem Cyber Breach to Foreign Nation
    Associated Press (01/06/17)

    Investigators say a foreign government was likely behind a cyber breach of health insurance company Anthem Inc., which compromised more than 78 million consumers' records. The California Department of Insurance says Anthem has agreed to make $260 million worth of improvements to its information security systems.

    ACA Repeal Would Put Budget in the Red by $350 Billion
    BenefitsPro (01/05/17) Satter, Marlene Y.

    It may be Republicans' first order of business in 2017, but repealing the Affordable Care Act will boost the country's budget deficit by $350 billion over 10 years. That's according to a new study from the Committee for a Responsible Federal Budget (CRFB).

    Orthopedic Center Requiring Up-Front Payments From State Workers
    State Journal-Register (IL) (01/05/17) Olsen, Dean

    With delays in state payments to health care providers at record levels, a Springfield medical group has begun to require patients insured by the state to pay half of their expected surgery bills up front before any work takes place. The requirement from the Orthopedic Center of Illinois comes at a time when payments for the care of state workers, retirees and dependents insured through the State Employees' Group Insurance Program total $3.66 billion and are overdue 18 months or more.

    Dosher Opposes 'Operating Room' for Which Two Firms Are Competing to Locate in Leland
    State Port Pilot (01/05/17) Pope, Terry

    A proposal to allow construction of an operating room in northern Brunswick County is vehemently opposed by both administrators and trustees for Dosher Memorial Hospital in Southport. Two entities have filed competing applications for a state “certificate of need” to build an additional operating room in the county.

    Promising Outcomes Seen With Outpatient Surgery for Ankle Fractures
    Orthopedics Today (01/17) Jaramillo, Monica

    Investigators of this study that compared inpatient and outpatient open reduction and internal fixation for ankle fractures found a reduced risk of certain 30-day medical morbidities with outpatient procedures and no differences in surgical morbidity, reoperations and readmissions. Researchers identified patients who underwent open reduction and internal fixation for an ankle fracture.

    Transforming Health Care Delivery Through the CMS Innovation Center: Better Care, Healthier People, and Smarter Spending
    CMS Blog (01/05/17) Conway, Patrick

    We have made great progress in recent years on reforming our system into one that delivers better quality of care for patients and pays for care in a smarter way, including investing more in prevention and primary care. Before 2010, there had been only modest efforts to improve care and reduce costs. Medicare--the country’s largest health care insurance program--was largely paying for health services based on volume--where providers were paid for every service they ordered or performed--which didn’t necessarily improve the health of beneficiaries or preserve the program for future generations.

    Dems Target HHS Nominee Price for Delay, Call for Ethics Probe
    Washington Times (01/05/17) Dinan, Stephen

    Democratic leaders demanded an investigation Thursday into President-elect Donald Trump's nominee to head Health and Human Services, saying there are indications Rep. Tom Price may have engaged in insider trading based on secrets he knew as a member of Congress. Senate Minority Leader Charles E. Schumer said Mr. Price's confirmation hearings should be put off until after an investigation is completed by the Office of Congressional Ethics, an independent House watchdog--a process that could take months, and leave the nominee in limbo.

    Study Questions Post-Colonoscopy ED Visit as Quality Indicator
    General Surgery News (12/19/16) Helwick, Caroline

    Patients whose endoscopists have high adenoma detection rates (ADRs) are at an increased risk for a trip to the emergency department (ED) within a week of their colonoscopy, researchers have found. The risk for a visit to the ED is fourfold higher for patients who undergo endoscopic mucosal resection and sevenfold higher for those who went to the ED within the past month compared with colonoscopy patients who did not have these characteristics.

    New Sensor Integrates Inflammatory Bowel Disease Detection Into Colonoscopy Procedure
    Business Wire (01/04/17)

    Researchers have developed the first sensor capable of objectively identifying inflammatory bowel disease (IBD) and distinguishing between its two subtypes. The device represents a substantial achievement toward a more personalized approach to diagnosing and treating IBD, a chronic inflammation of the gastrointestinal tract affecting more than 1 million Americans.

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