Message from the President

Tackling 2022’s Challenges Head On

This is the time of year when we start to find out what the new year will look like, how our budgets will match expectations, what our volumes will be and all the other details that go with planning for the year. For those of you who thought the fiscal year 2021 budget process was going to be a challenge, welcome to 2022.

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Message from the CEO

Attend ASCA’s Coding Seminar

We are right in the middle of fall, and as the leaves swirl around and you sip your pumpkin latte, let me ask: Have you signed up for ASCA’s coding seminar yet?

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As I See It

How to Handle Improper Physician Conduct

Hire wisely, mandate regulatory and legal compliance and have clearly written agreements and policies

Perhaps more than any other factor, the success of an ASC depends on the surgeon-owners who refer and perform cases there.

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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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Procedure Shift to ASCs Continues

How existing health systems are responding

ASCs are proliferating nationwide. At the ground level, however, markets vary substantially in their pace of procedural shift into ASCs, leaving legacy health systems’ share and revenue vulnerable to varying degrees.

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Total Joint Replacements Move Outpatient Faster than Anticipated

Four considerations for ASCs preparing to harness the trend

Total joint replacement (TJR) surgeries have been steadily migrating from inpatient to outpatient settings in recent years, and that trend is building momentum even faster than previously anticipated. We believe that at least 70 percent of TJR surgery volume, perhaps more, can now be outpatient.

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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

A Look at the Biden Administration’s Health Actions in Year One

The pandemic and partisan gridlock shaped the new president’s appointments and priorities

On January 20, 2021, Joseph R. Biden was sworn in as the 46th president of the United States. He assumed responsibility during a pandemic that had already killed more than 400,000 Americans.

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Advocacy Spotlight

State Legislative Trends in 2021

States return to considering issues other than COVID-19

After spending most of 2020 grappling with the COVID-19 pandemic, state legislatures in 2021 were able to dedicate more time to addressing other concerns, even though legislation related to the pandemic still featured heavily on legislative dockets.

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Member Profile

Robert J. Carrera

Robert J. Carrera discusses the most important issues in the ASC industry in 2022 and going forward.

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ASCA 2022: Back in the Saddle Again

For more than two decades, ASCA’s annual conference has remained the premier, can’t-miss event for the ASC community, and this year we will back in person. The ASCA 2022 Conference & Expo will take place April 27–30 in Dallas, Texas.

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Web Crawl

Renew Your Membership for 2022

If you have not already renewed your ASCA membership, act now to avoid losing access to this magazine and other vital ASCA member benefits.

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