Message from the President

COVID-19 Pandemic Drives Use of New Technology

Telehealth use has increased to 38 times its pre-COVID-19 baseline, according to McKinsey & Company. A year ago, $250 billion of US healthcare spend was estimated to be shifted to virtual care; post COVID-19, telehealth could be a quarter-trillion-dollar industry.

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Message from the CEO

Medicare’s 2022 Proposed Payment Rule a Mixed Bag for ASCs

During July, Medicare released its 2022 Proposed ASC Payment Rule. Medicare officials are collecting and reviewing comments on that proposal now, preparing to release a final rule.

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As I See It

Focus on Price Transparency

Make it a front-end operation and improve clean claim rates

Encouraged by growing interest in consumerism and the need for healthcare cost containment, the US Department of Health & Human Services adopted a new hospital price transparency rule that went into effect January 1 this year.

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Doing Business

Deliver Personalized Care in the Age of Machines

Involve your nurses when making technology decisions

A few significant developments are motivating ASCs to invest in information technology (IT) solutions. Centers that must compete with hospitals or other ASCs will want to be perceived as a leading care provider, which includes keeping current with technology.

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History and Role of MedPAC

Where do ASCs fit in

On two mornings every month between September and January, a long line of people waits to enter a wood-paneled meeting room in the Ronald Reagan Building in downtown Washington, DC. Whether they are lobbyists, regulatory consultants or patient advocates, the people in line all have a special interest in health policy.

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Host Facility Tours

Educate your lawmakers and advocate for ASCs

In 2019, ASCA members hosted facility tours for state and federal lawmakers representing diverse constituencies across the country. These tours helped shore up support for ASCs among longstanding legislators and introduced new state and federal officials to the ASC setting.

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Emerging Trends in the Face of the Pandemic

The virus has enhanced the appeal of ASCs by highlighting their strengths and advantages

Prior to the ongoing coronavirus pandemic, the national ASC market was already experiencing substantial growth due to its placement across two converging trends: the consumerization of healthcare services and the ongoing industry-wide transition from fee-for-service care to value-based care.

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Nap Gary’s Legacy Continues Through ASCA Lifetime Award

Who can nominate and how

The ASCA Board of Directors established the Nap Gary Legacy Award for Lifetime Achievement in the ASC Community to recognize individuals whose contributions have made a difference in the ASC industry.

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In Memoriam

ASC community remembers a beloved leader

Randy Leffler, 51, executive director of the Ohio Association of Ambulatory Surgery Centers (OAASC), passed away last December.

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Q & A

ASCA CEO Discusses Proposed 2019 ASC Payment Rule

A Q&A with Bill Prentice

On July 25, the Centers for Medicare & Medicaid Services (CMS) released the 2019 proposed payment rule for ASCs and hospital outpatient departments (HOPD). ASCA Chief Executive Officer Bill Prentice talks about the policy changes proposed and the implications of those changes for ASCs.

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Hurdles Slowing Down Migration of Procedures

Barriers to moving complex procedures from HOPDs to your ASC

CY 2021 brought policy and reimbursement changes that would seem to position ASCs favorably for an obvious migration of cases from the hospital outpatient department (HOPD) to the ASC.

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Improve Claim Compliance

Use correct modifiers

In the coding world, modifiers are two-digit symbols added to CPT procedure codes to signify the procedure has been altered in some way.

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How Plans of Correction Work

Why ASCs should embrace them

When it comes to state agency or accreditation organization surveys, preparation is key and preparing and implementing a plan of correction (PoC) can help ensure ongoing compliance and quality improvement (QI).

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Remove the Stigma of Sentinel Event Reporting

The Joint Commission can work with your ASC to analyze, correct and prevent future errors

The Joint Commission defines a sentinel event as “a patient safety event that reaches a patient and results in any of the following: death, permanent harm, [or] severe temporary harm and intervention required to sustain life.”

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HIPAA Biannual Update

July to December 2018

Since ASCA’s last update in July 2018, healthcare organizations across the country posted 163 breaches of protected health information (PHI) affecting 500 or more individuals.

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Legal Matters

Informed Consent Process in Ambulatory Surgery

Review state laws and AHRQ materials before creating your policy

In rare situations, the duration of the informed consent could present an issue. Some state laws presume that a written authorization signed by the patient is valid. Some states might specify the time frame in which consent remains valid; others require that consent be obtained no more than 30 days from the procedure. Therefore, checking state regulations is essential.

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Build a Data-Driven Marketing Program

Foster relationships by eliminating the guesswork

Relying on word-of-mouth to cultivate awareness is not enough to establish and build reputation among potential patients in today’s competitive healthcare marketplace. Patients are using various means to shop for and select their care providers, and it is helpful to have a marketing program that connects with people as they consider options.

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Trends in Medical Risk Transfer

Risks that are uninsurable or prohibitively expensive to insure might call for alternative risk transfer

In an ever-changing world, it is no secret that risks associated with ASCs also are evolving. Trends in medical risk transfer, however, are generally not related to ordinary risks but rather nontraditional—low frequency/high severity—risks. If these risks occur, they have the ability to bring a practice to a screeching halt. Examples of such risks include: loss or suspension of professional license, legislative and regulatory changes, cyber risk (breach of customer data and detrimental code) and related Health Insurance Portability and Accountability Act of 1996 (HIPAA) violations.

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ASCA Advocates for Fair Implementation of Section 603

Congress passes site-neutral payment legislation

On November 2, 2015, congressional leaders and the Obama administration announced a bipartisan budget agreement that would fund the federal government for two years, raise the nation’s debt ceiling and stave off Medicare premium increases for beneficiaries. The final legislation, called the Bipartisan Budget Act of 2015, responded to a number approaching fiscal deadlines and leadership changes in the US House that could have impacted the ability to strike such a deal.

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Quality Improvement

Stay on the Forefront of Efficiency and Quality

Consider these new strategies

During the last 27 years, as an ophthalmic surgeon, I also was part owner of an ASC in Washington, DC. While I was able to transition successfully, I wish I had had many of the tools and features available today that would have made my life easier and my business more profitable.

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Air-Cleaning Options for Facility Hygiene

Purification systems and UV-C technology help reduce the spread of infectious particles

Now that we know that COVID-19 can be airborne during medical procedures that generate aerosols, implementing technologies and best practices that limit the potential exposure of pathogens in aerosols has become essential.

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Infection Prevention

Build an Effective Infection Prevention Program

Rely on sound policies, careful training and accountability

ASC employees often wear multiple hats and fill multiple roles that are normally individualized at larger facilities. In some cases, surgery centers have tight reprocessing areas or limited equipment, tools or chemistries to reprocess devices. Having access to the most updated instructions for use (IFU) is critical for success in this field and these situations.

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Preparing for and Responding to a Data Breach

Have a written plan, implement it in a timely manner and communicate with your patients

ASCs are attractive targets for cybercriminals. Surgery centers collect and store vast amounts of sensitive personal information. This is highly valued as it can be used for identity theft, blackmail and extortion.

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Staying Afloat during and after the Pandemic

Keep a close eye on your revenue cycle

While the COVID-19 pandemic underscores the need for outpatient surgery to be available outside the hospital setting, ASCs across the country continue to grapple with revenue cycle challenges presented by pandemic-related slowdowns in case volume and reimbursement from payers.

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Is Your Billing Team Performing Optimally?

Take a deep dive into your processes to decide

Your ASC is well-positioned in the community. It has a good reputation, as do your providers. Your caseload is steady or perhaps growing. You have a happy, busy staff.

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Regulatory Review

Patient Experience Survey Likely Coming for ASCs

What you need to know to be ready

The patient experience is often cited as a primary selling point for going to an ASC for an outpatient procedure. Patients appreciate the convenience of ASCs and the fact that limiting our facilities to outpatient elective procedures better controls the environment and limits patient exposure to potential healthcare-acquired infections, which during a global pandemic is more important than ever.

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Advocacy Spotlight

Connecticut Overhauls ASC Gross Receipts Tax

Multiyear advocacy effort finds success

Connecticut Governor Ned Lamont (D) signed a two-year state budget implementer bill, SB 1202, into law in June. The budget implementer contained policy provisions impacting various state laws, including one with big implications for ASCs: an overhaul of the state’s ASC gross receipts tax.

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Member Profile

Sandra Jones, CASC

Sandra Jones, CASC, president and chief executive officer of Ambulatory Strategies Inc. in Dade City, Florida, shares her best tips for emergency preparedness compliance with Centers for Medicare & Medicaid Services (CMS) requirements.

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Renew Your Membership for 2022

Make sure you can continue to take advantage of all your member benefits, including this magazine, by renewing your membership on time. Members can renew online or by emailing Mykal Cox and requesting an invoice.

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Web Crawl

Save the Date for the ASCA 2022 Virtual Coding & Reimbursement Seminar

Mark your calendar for the ASCA 2022 Virtual Coding & Reimbursement Seminar, taking place over three half days on January 10, 18 and 24, 2022.

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