As I See It

AS I SEE IT

Ins and Outs of H&P

The minimum requirement for a preop history and physical (H&P) is well defined in the Centers for Medicare & Medicaid Services’ (CMS) Conditions for Coverage (CfC).

  1. According to §416.52 Conditions for Coverage Q-0261 (Rev. 71, Issued: 05-13-11, Effective: 5-13-11-Implementation: 05-13- 11) §416.52(a) Standard: Admission and Pre-surgical Assessment: Not more than 30 days before the date of the scheduled surgery, each patient must have a comprehensive medical history and physical assessment completed by a physician (as defined in section 1861(r) of the Act) or other qualified practitioner in accordance with applicable State health and safety laws, standards of practice, and ASC policy. (Please check your state and accrediting body requirements to ensure you will not be held to a more stringent timeframe).


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Patient Safety, It Is Everyone’s Job

Every time a patient enters a surgery center, they entrust their life to the facility and its staff. A patient rightfully expects that every precaution will be taken to keep them safe while in the center’s care. Strict policies and procedures are in place to ensure that everyone, physicians included, follows patient safety rules.


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The Complex Case Conundrum

Thanks to advances in technology, many historically complex orthopedic and spine procedures have become much less invasive. As a result, many of these cases are now well-suited for outpatient environments, especially ASCs, which have a strong track record of affordable, quality care and positive patient outcomes.


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The Value Proposition for ASCs

Mike Williams is production manager for a small manufacturing company in middle Tennessee. He and his wife bring home around $52,000 per year, which is the average annual income for families in the US. Mike and his family get their health coverage from an exchange plan that costs $13,000 per year, or about one-fourth of their annual income, before providing any actual health services. Earlier this year, Mike injured his knee playing football with his two sons, which earned him a visit to an orthopedic surgeon and the need for a knee arthroscopy. After receiving a quote from the hospital for $9,200 and considering his $5,000 deductible and 20 percent coinsurance, Mike decided to live with his knee pain.


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Use Data to Your Advantage

Change remains the one constant in health care today. From payer behavior to increased patient financial responsibility, and price transparency to value-based medicine, old assumptions are no longer valid.

Data is helping leading health care organizations find clarity in this new landscape, clinically and operationally. Increased information sharing across health systems is leading to better outcomes, as opportunities for collaboration and access to high-quality specialty care increase. It is also helping executives and managers make better business decisions faster.


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Running an Effective Board Meeting

A strong, effective board can transform an organization from good to great and position your ASC as the leader in your market. Conversely, a weak, disengaged board can drive an organization slowly into the ground, making uninformed decisions and missing competitive opportunities. Since you meet with your board only a limited number of times each year, the effectiveness of those meetings is an important aspect of the effectiveness of your board.


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Breast Cancer Surgery in the ASC Setting

ASCs today are adapting to multiple shifts in the health care and financial environments. Among the many challenges they face as this evolution continues are changing reimbursement, more knowledgeable patients who evaluate their health care options with that knowledge in hand and increased competition from hospitals that purchase physician practices.


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CPT Coding Change

A seemingly small coding change made by the American Medical Association (AMA) recently could mean big overhauls in the way that many ASCs perform and report a popular pain management procedure.


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Leadership Development in the ASC

Having served in the US Navy, I cannot help but see many similarities between an ASC administrator and the captain of a ship. Like a ship captain, the administrator has ultimate responsibility for the organization, which is serving a mission where lives are often at stake. The success of the mission relies on the team and its leadership.


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Industry Outlook

There is no doubt the health care landscape is changing. Burgeoning health care expenditures, our aging and active population and advances in medical technologies are fundamentally changing the way everyone views health care. Massive consolidation in virtually every sector of health care is dramatically shifting the playing field, and these mergers have enormous implications for the ASC industry. ASCs are uniquely capable of reacting quickly to all these changes, and the ASC industry’s strategic position within this competitive health care environment will likely trigger unprecedented growth in the number of surgeries performed at ASCs.


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