ASCA News Digest (July 31, 2018)

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July 31, 2018

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ASCA Highlights



Last week, the Centers for Medicare & Medicaid Services (CMS) released the 2019 proposed payment rule for ASCs and hospital outpatient departments (HOPDs). Of note, CMS has addressed a number of long-requested ASCA priorities, including proposing to align update factors and moving ASCs to the hospital market basket that is used to update HOPD payments. Under the proposal, CMS would use the hospital market basket to update ASC payments for the five-year period of calendar year (CY) 2019 through CY 2023. Read on for other initial ASCA observations about the 761-page proposal.
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DePuy Synthes    Why did you start performing total joint replacements at the surgery center?

Data collection for the second quarter (Q2) of ASCA’s 2018 Clinical & Operational Benchmarking Survey closes today at 11:59 pm ET. This online resource allows you to compare your ASC's metrics with national performance statistics on clinical outcomes, staff indicators, billing performance and more. Q2 reports will be available on August 15. Not yet subscribed to the 2018 survey? Purchase a subscription now.
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ASCA is excited to announce that the application period for the first-ever Certified Ambulatory Infection Preventionist (CAIP)™ exam opens tomorrow, August 1. CAIP is the first credential designed specifically for infection preventionists in the ASC industry. The application period for the Certified Administrator Surgery Center (CASC)™ exam will also open on August 1; both periods will close Friday, August 31. The exam periods for both credentials is October 1–31.
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This year, ASCA has expanded the celebration of National ASC Week into a full month! For all of August, ASCs around the country will participate in National ASC Month by opening their doors to the public and hosting facility tours. This is a great way to promote awareness to both your local policymakers and the public of the high-quality, cost-efficient surgical care that ASCs provide.

If your ASC is planning to participate in any National ASC Month events, please let Danielle Kaster know right away.
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On July 24, the US House of Representatives passed the Ambulatory Surgical Center (ASC) Payment Transparency Act of 2018 (H.R. 6138)—a major development for ASCA’s agenda. The legislation would add an ASC industry representative to the Centers for Medicare & Medicaid Services’ (CMS) Advisory Panel on Hospital Outpatient Payment and require CMS to disclose the criteria it uses to exclude procedures from the ASC Medicare procedures list. The next step for this bill is introduction in the US Senate. Read more.
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Industry News


A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests
New York Times (07/23/18) Sanger-Katz, Margot

Back in 2010, Tom Price, then a congressman, said he knew the chief reason health care cost so much: "Defensive medicine" was costing the United States $650 billion per year — about 26 percent of every dollar spent. The widely dismissed estimate from Dr. Price, an orthopedic surgeon who went on to become President Trump’s health and human services secretary before resigning last fall, was memorable for its magnitude.

CMS Empowers Patients and Ensures Site-Neutral Payment in Proposed Rule
CMS Press Release (07/25/18)

Today, the Centers for Medicare & Medicaid Services (CMS) took steps to strengthen the Medicare program with proposed changes to ensure that seniors can access the care they need at the site of care that they choose. In addition, as part of the agency’s ongoing efforts to lower drug prices as outlined in the President’s Blueprint, CMS included a Request for Information on how best to develop a model leveraging authority provided to the agency under the Competitive Acquisition Program (CAP) to strengthen negotiations for prescription drugs.

Malignant Hyperthermia: A Deadly, Yet Treatable Emergency – Be Prepared!
Joint Commission Ambulatory Buzz blog (07/25/18) Daugherty, Dianne

A malignant hyperthermia (MH) event is a biochemical chain reaction response triggered by commonly used general anesthetics and the paralyzing agent succinylcholine (a neuromuscular blocker) within the skeletal muscles of susceptible individuals. Epidemiologic studies reveal that MH complicates about one in about 100,000 surgeries in adults and one in about 30,000 surgical procedures in children.

Brunswick Boom: First Orthopedic Surgery Center Being Constructed
WWAY NewsChannel 3 (07/26/18)

As the Brunswick boom continues, the first orthopedic surgery center is officially going up in Brunswick Forest. EmergeOrtho broke ground on its newest location Thursday morning.

Physician Burnout: Professional Identity Could Be Key Factor
Health Leaders Magazine Online (07/18) Cheney, Christopher

The practice of medicine has changed in ways that are damaging the professional identity of physicians and fueling burnout, a cardiologist and medical school professor says. Knowledge is at the heart of the physician identity, says John E. Brush Jr., MD, FACC, a cardiologist at Sentara Healthcare in Norfolk, Virginia, and professor of medicine at Eastern Virginia Medical School in Norfolk.

Survey: Progress on Patient Safety Slowed by Ineffective Technology, Healthcare Professionals Say
PR Newswire (07/19/18)

Nearly nine out of 10 respondents to a national survey of physicians, nurses and healthcare executives say their organizations are successfully improving the safety of patients. But real problems remain, and to make further improvements, respondents to the Health Catalyst survey said they need better health information technology to warn clinicians of impending patient harm, as well as more resources and greater organizational focus on the problem.

Medicare's Hospital Outpatient Prospective Payment System Proposed Rule: Big Changes for 2019
Health Affairs Blog (07/27/18) Wynne, Billy

On Wednesday, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2019 hospital outpatient prospective payment system (OPPS) proposed rule addressing payments to hospital outpatient departments and ambulatory surgery centers (ASCs). In the proposed rule, CMS made several significant proposals, including to expand a controversial policy that pays off-campus hospital departments at the same rate as physician clinics and to extend cuts for 340B-related drugs to such sites as well.


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