Features

Features

Battling the Opioid Crisis

Responsibilities of ASCs

The opioid crisis presents both a challenge and an opportunity for ASCs, says Amy Mowles, president and chief executive officer of Edgewater, Maryland-based Mowles Medical Practice Management, an ASC regulatory and development company.


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Develop a Win–Win Cash-Pay Program

Know your procedure costs, set fees that ensure a reasonable margin and keep your costs low

Looking to grow your case volume while accommodating the needs and wishes of patients from within— and even potentially outside—your community? Consider offering a cashpay program, say ASC managers who are already offering this option.


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Use Benchmarking to Drive QAPI

ASCs nationwide are using ASCA Benchmarking to improve their performance

The clinical staff at Lakeview Surgery Center in West Des Moines, Iowa, believed their patients always received their prophylactic intravenous (IV) antibiotics “on time,” recalls Kate Foreman, the ASC’s quality coordinator.

“On time,” according to the definition used in Medicare’s ASC Quality Reporting (ASCQR) Program’s ASC-5: Prophylactic Intravenous (IV) Antibiotic Timing measure meant these antibiotics were initiated within one hour prior to the time of the initial surgical incision or the beginning of the procedure, or two hours prior if Vancomycin or fluoroquinolones were administered.


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Changes in Accreditation

Three accrediting agencies explain upcoming modifications in their standards

The Accreditation Association for Ambulatory Health Care of Skokie, Illinois, the American Association for Accreditation of Ambulatory Surgery Facilities of Gurnee, Illinois, and The Joint Commission of Oakbrook Terrace, Illinois, described the upcoming changes in their standards for ASC Focus. Learn what to expect from your survey experience, the steps you need to take to stay on top of your game and how to comply with the changed standards.


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Modifying to Achieve Interoperability

In the absence of CEHRT, ASCs adapt to reach clinical integration

If an ASC needs to participate in the continuity of care across a surgical episode, it needs to have an IT system that speaks to a physician partner’s electronic health records (EHR), says Roy Georgia, partner in the ASC Division of ICE Technologies, headquartered in Pella, Iowa. “Herein comes the need for interoperability,” he says. “With a lot of consolidation in the ASC software space, there is going to be more standardization and increased adoption of EHR products. With that, there will be a more specific need for interoperability.”


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Invest in IT to Support Your ASC’s Growth

Look beyond the price tag, choose carefully

Electronic medical records (EMR). Patient portals. Electronic scheduling. Patient tracking. Analytics.

ASCs, today, have their choice of many different types of information technology (IT) systems and many different suppliers. The IT systems have tremendous potential to help ASCs achieve their growth objectives, says Paul Davis, chief executive officer and president of Amblitel, a provider of ASC accounting and back-office services based in Louisville, Colorado.


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Implement an Effective Peer Review Program

Stay on track with an ongoing, active process

The primary focus for everything that happens at the Orthopedic Surgery Center of Orange County in Newport Beach, California, is patient safety, says Karen Ollila, the ASC’s operations manager. Peer review, she says, is a critically important part of that focus.


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Use Information Technology Effectively

Staff training is key

An ASC that wants to capitalize on its investment in information technology (IT) has to invest in training staff to operate the new system, says Matt Petty, senior vice president of IT for Surgery Partners, a nationwide operator of surgical facilities based in Nashville, Tennessee.


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Know Your State’s Nursing Scope of Practice Definitions

Educate yourself to avoid adverse outcomes and litigation

The term “scope of practice” has different definitions in policy and professional documents, which is why it is critical to know how your state’s regulations define the term, says Debra Stinchcomb, RN, CASC, consultant with Progressive Surgical Solutions in Fayetteville, Arkansas.


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Creative Staffing Strategies for Highest Efficiency

Adaptability and flexibility play key roles

Staffing optimally to achieve the greatest productivity while keeping your staff happy can be challenging. Administrators at three different ASCs share their secrets to success.


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Recruiting and Retaining Physicians

Develop a long-term plan, be responsive to your doctors’ needs and make sure staff is happy

Between November 2014, when Jennifer Morris became the administrator of Surgicare of Wichita in Wichita, Kansas, and May 2017, the ASC added 26 physicians across seven specialties. She says that part of the reason for that is because she is always working on physician recruitment since it is vital to sustaining an ASC.


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Cost Savings in Human Resources

Hire smart, cross-train and keep staff morale high

When Sarah Malaniak, CASC, was brought on as administrator for the Ambulatory Center for Endoscopy in North Bergen, New Jersey, one of her first assignments was to tackle the ASC’s overtime problem.


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Getting Staff to Buy Into Change

Communicate clearly, gain staff support and hold employees accountable

Gaining staff support is essential for a change to achieve its desired outcome, says Don Bartnick, chief executive officer of Annapolis Surgery Center in Annapolis, Maryland, and Maryland Eye Surgery Center in Prince Frederick, Maryland.


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Medication Management Hot Spots

Accreditation standards that can challenge ASCs

When The Joint Commission looked at the 10 most challenging accreditation guidelines for ASCs in 2016, it found that three of the 10 were related to medication management.


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Working with Compounding Pharmacies

Check accreditation, state registration and licensure, and FDA track record

Compounding pharmacies can play an important role in supplying ASCs with medications they need to provide patient care, says Sharon Johnson, RN, CASC, senior vice president of operations for ASC management and development company Ambulatory Surgical Centers of America, based in Hanover, Massachusetts.


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Winning Over Patients through Engagement

Participation leads to better outcomes

Montgomery Surgical Center in Montgomery, Alabama, considers patient engagement to be a vital component for a successful surgical experience, says Linda Westhoff, RN, CASC, the ASC’s administrator.


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Screening Colonoscopy Program Reaps Rewards

‘Scopes for Hope’ at Surgery Center of Farmington sees early success

Last year was a difficult year for the gastroenterology service line at the Surgery Center of Farmington in Farmington, Missouri, says Cindy Young, RN, CASC, the ASC’s administrative director. After starting the year with five gastroenterology physicians, only one remained at the end.


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Virtual Marketing

How to create and maintain a social media site

More than 3 billion people use the Internet and more than 2 billion of those users have active social media accounts, according to an August 2016 Hootsuite column. Given the widespread use, social media is no longer optional for businesses, says Kelly David, director of marketing and public relations at Spectrum Medical Group in Portland, Maine. “The more we become patient and customer focused, the more important a tool social media becomes to connect.”


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ASCA 2017 Convenes in Washington, DC, this Month

Take advantage of more than 60 educational sessions and advocate for your ASC

At a time when Washington, DC, is under the world’s microscope, it seems fitting that ASCA is bringing the ASC community into the heart of the action at ASCA 2017, May 3–6, at the Gaylord National Resort & Convention Center in National Harbor, Maryland.

“Attending an ASCA meeting continues to be an unparalleled opportunity for all attendees, regardless if it is your initial meeting or your 25th,” says Jo Vinson, CASC, director of integration management for Deerfield, Illinois- based Surgical Care Affiliates.


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Protecting Patient Information

Train staff to maintain data security and privacy

Even in an ASC with great information technology infrastructure, human error can open the door for cyber criminals, says Tracy Rubino, privacy officer of ambulatory surgery centers for not-for-profit health system Sutter Health in Sacramento, California. In fact, Verizon’s 2016 Data Breach Investigations Report cites human error as one of the leading causes of health care cyber security incidents.


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Cyber Insurance and Your ASC

Reduce your risk and the cost of protection

ASCs need to prepare for the possibility of a data breach and be ready to respond if it happens, says Michael Wells, chairman of Hylant of Indianapolis, an insurance brokerage and risk management solutions provider in Indianapolis, Indiana.


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Navigating Coding Modifiers

What ASCs need to be on the lookout for

Coding modifiers—usually two digits—can increase or decrease reimbursement and cause claims not to be paid properly or denied if used incorrectly or not used when necessary. “Modifiers are added to the main procedure code to signify that the procedure has been altered by a distinct factor,” says Stephanie Ellis, RN, president of Ellis Medical Consulting Inc. in Franklin, Tennessee. “Modifiers are accepted by most payers.”


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Using Lean Six Sigma

Streamline production, eliminate waste and improve efficiency

For an ASC striving to bring about improvements throughout the facility, applying Lean Six Sigma principles can be an effective method to achieve desired results, says Erin Huston, RN, the Lean Six Sigma Black Belt continuous improvement specialist for The Urology Group and its ASC, The Urology Center, in Cincinnati, Ohio.


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Value-Based Care in Today’s ASC Market

Surgery centers should seize the opportunity

Regardless of the changes that will be made to the US health care system in the coming years, at least one thing seems to be certain, says Gregory Horner, MD: Value-based care is here to stay. Horner, an ASCA Board member, works as a managing partner at HealthPoint Ambulatory Surgery Company, an ASC management and development company in Newbury Park, California.


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ASCs and Post-Acute Services

Skilled nursing facilities would work with surgery centers

Andy Whitener is the chief executive officer and administrator of Gainesville Surgery Center in Gainesville, Georgia, an affiliate of Surgical Care Affiliates. Write him at Andy.Whitener@SCASurgery.com.


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Stay on Top of Water Quality

Avoid contaminants with careful testing and vigilance

What you do not know about your ASC’s water could harm patients and damage devices, says Barbara Ann Harmer, RN, director of clinical services for Innovative Sterilization Technologies in Dayton, Ohio, a company that developed and markets a sealed sterilization container system.


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Tips on Implant and Supply Management

Reduce costs, increase value, maintain choice

Knowledge is power when it comes to getting a good price on implants, says Tim Burney, founder and chief executive officer of Advantien in Greenwood Village, Colorado. “You need to know the market and your alternatives,” he says. “Do not accept that you cannot get the same price as the hospitals. You can, believe me, you can.”


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Lessons Learned Operating ASCs in Low-Income Areas

Be cognizant of financial obstacles and cultural differences

Running an ASC in a low-income area is fraught with risks, delays in payment, demands from the Department of Health and the fire department, and other adverse factors, says Roy Bejarano, president of Frontier Healthcare in New York, New York. “It is a fragile and delicate situation,” he says. “ASCs, however, are the smarter health care option for low-income areas because they offer high-quality care at a lower cost than hospitals and are more specialized than hospitals.”


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Continuity of Operations Planning in ASCs

Effective communication, drills and working with your local organizations are key

In a disaster, either natural or manmade, continuity of operations planning helps an ASC protect and preserve its critical infrastructure, says Lynne Bergero, project director for the division of health care quality evaluation at The Joint Commission in Oakbrook Terrace, Illinois.


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Calculate Your ASC’s OR Cost Per Minute

ASCs that do can reduce expenses and improve contracts

Do you know what it costs when patients are in your ASC’s operating room (OR), asks Ann Geier, RN, CASC, chief nursing officer for SourceMed, a Birmingham, Alabama-based provider of software and ASC advisory services for ASCs and other organizations. Since the OR is where an ASC generates revenue, she says, understanding the costs incurred there is an essential management tool for an ASC.


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Join ASCA on Capitol Hill

Sign up for National Advocacy Day when you register for ASCA 201

As rising costs, inadequate payment updates and the steady growth of hospital-employed physicians continue to threaten ASCs, ASCA’s ongoing efforts to promote the interests of the ASC community before the legislative and regulatory bodies that set ASC policies grow increasingly important. The success of ASCA’s advocacy efforts, however, relies on the participation of everyone in the ASC community.


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Benchmark Your Revenue Cycle

Gauge the health of your ASC’s collections, billing processes and contracts

If you do not know how your ASC’s revenue cycle is performing, you will not know how to improve it says Crystal Ewing, manager of data integrity for ZirMed, a provider of claims management solutions based in Louisville, Kentucky.


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In the Pipeline

ASCA’s 2017 advocacy agenda

In 2017, ASCA will be working on many levels with multiple regulatory agencies and Congress to ensure that ASCs are at the table and in the conversation when federal policy decisions that affect surgery centers are made.


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ASCA Lobbies for Your ASC

Meet the Government Affairs team

ASCA’s Government Affairs Department leads ASCA’s efforts to promote the interests of the ASC community before federal and state legislative, regulatory and executive agencies. Working with state ASC associations and industry leaders, the department staff identify and analyze critical health policy issues concerning ASCs and act to enhance and protect each ASC’s ability to continue providing high-quality patient care.


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Achieving and Sustaining a Culture of Patient-Centric Care

Government support continues to grow

The culture that an ASC is aiming for doesn’t just develop naturally, says Jo Ellen Braden, RN, CASC, quality assurance performance improvement (QAPI) coordinator at Taylor Station Surgical Center in Columbus, Ohio. It requires hard work and commitment.


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ASCAPAC Thanks Its Supporters

These contributions ensure that the ASC message is heard in Congress

ASCAPAC is the only political action committee in Washington, DC, that represents the interests of the entire ASC community. Through the contributions it receives, ASCAPAC helps ensure that the policymakers who support and understand the importance of the ASC delivery model remain in Congress.


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Managing Drug Shortages

As FDA requirements changed, manufacturing costs escalated, production decreased and needs increased

Drug shortages continue to be a challenge for ASCs as they impact providers with little or no warning and potentially threaten patient safety, says Norman Tomaka, clinical consultant pharmacist in Melbourne, Florida.


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Changing Hospital Model and Its Impact on ASCs

The numbers of community hospitals and ASCs are going in different directions

It is a good time to own an ASC, says Mark Weiss, an attorney with The Mark F. Weiss Law Firm, which has offices in California and Texas.

“The health care landscape is changing quickly, and ASCs look to be positioned for success,” says Weiss, the author of The Impending Death of Hospitals: Why You Must Plan Your Medical Practice’s Survival and other health care books. “The evolving hospital model is creating a growing pool of potential opportunities for surgery centers.”


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Reversing the National Trend of Opioid-Related Overdoses

What ASCs can do

The Centers for Disease Control and Prevention (CDC) reports that more people died from drug overdoses in 2014 than any other year on record (www.cdc.gov/drugoverdose/ epidemic/index.html). A majority of drug overdose deaths—more than 60 percent—involve an opioid. And nearly 80 Americans die daily from an opioid overdose.


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Outcomes of Spine Surgery in an ASC

Patient selection and tracking metrics under bundled care

The number of anterior cervical discectomy and fusion (ACDF) surgeries, one of the most common spine procedures performed in the US today, continues to rise as a result of the growing elderly population in the country, says Anthony L. Asher, MD, ASCA Board member, director of the Neuroscience Institute at Carolinas HealthCare System and a senior partner at Carolina Neurosurgery and Spine Associates in Charlotte, North Carolina.


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Bundle Up

Will the bundled payment model work for ASCs?

The federal government has initiated broad adoption of bundled payment methodologies in inpatient settings including the Bundled Payment for Care Improvement (BPCI) initiative and, more recently, the Comprehensive Care for Joint Replacement (CJR) regulations. According to the Centers for Medicare & Medicaid Services (CMS) more than 500 hospitals now participate in these programs.


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Protect Your ASC from a Ransomware Attack

Prevention and backups are the best defense

Steven Sanchez, network administrator and facilities manager for Pend Oreille Surgery Center in Ponderay, Idaho, says ransomware is an issue of growing concern for his ASC. He points to the increasing number of organizations affected by this cybersecurity threat.


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The Rules of Medication Preparation

Train, monitor and audit

Rancho Bernardo Surgery Center makes medication preparation a constant area of focus, says Stephanie McIntosh, RN, administrator for the San Diego, California-based ASC. “Keeping it at the forefront of everyone’s mind is what keeps us vigilant with following regulations and proper practices.”


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Social Media and Your ASC

Avoid eight common mistakes

Social media usage has jumped nearly tenfold from 7 percent in 2005 when the Pew Research Center began tracking social media usage to 65 percent in 2015, according to an October 2015 Pew Research report. Consequently, there is increasing pressure on ASCs to develop an online presence, says Charlie Leonard, a public affairs adviser based in Santa Barbara, California.


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Power in Numbers

Work with your local authorities when creating your emergency preparedness plan

For Chris Bland, director of safety and security at Good Shepherd Medical Center and Good Shepherd Ambulatory Surgery Center in Longview, Texas, the definition of a disaster is when the need outweighs the resources.

“When you have an emergency or a natural disaster, your resources are overwhelmed and you need more resources than you have,” he says. “So you need help from your local police department, fire department and all other emergency responders.” Given that, it is in an ASC’s best interest to establish good relations with local authorities before disaster strikes, he says.


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Is Your ASC Equipped to Respond to Disasters?

Make emergency preparedness a top priority in your surgery center

For most ASCs, it is not a matter of if, but when they will face a disaster, says Anne Haddix, the disaster preparedness coordinator for the Indiana Federation of Ambulatory Surgical Centers and chief executive officer of Southwest Surgical Suites in Fort Wayne, Indiana. ASCs must ensure they are effectively prepared to respond when a disaster strikes, she says.


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Benchmark to Provide Best Quality Care

ASCA’s second generation clinical and operational program offers apples-to-apples comparison

Castle Surgicenter in Aurora, Illinois, benchmarks to ensure that it is providing the best quality, safest care possible, says Patricia Darimont, RN, the ASC’s clinical director. “If benchmarking reveals an opportunity for improvement, we work to make changes,” she says.


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Users Praise ASCA’s Online Training Series

Three new courses to be added in fall

ASCA will add three new courses to its Regulatory Training Series this fall: Hand Hygiene, Latex Allergy, and Prevention of Healthcare Associated Influenza. This addition will bring the total number of interactive courses in the series to 24, with 18 offering continuing education (CE) credits to facility learners. Current subscribers will automatically receive the new courses once they are released.


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How to Draft a Plan of Correction

Do it quickly and make sure that it is executable

Act fast, and take it seriously. That is the advice that retired Medicare surveyor and current regulatory and accreditation compliance consultant Bruce Ettinger, MD, of Santa Monica, California, has for ASCs that are required to submit a plan of correction (POC) to address deficiencies found during a Medicare survey. Ettinger is also an ASCA Board member.


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Ask an RN

The value of nursing input into ASC building design

Whether building a new ASC or expanding an existing facility, developers would be wise to include nurses on their design team, says Stephanie Leventis, RN, vice president of development for SurgCenter Development, an ASC development company based in Pismo Beach, California.


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Splash, Soap, Rinse, Dry

How to assess hand hygiene and stay compliant

Despite years of hard work to promote and attain hand hygiene compliance in the health care setting, the industry continues to struggle to achieve goals that are set by external agencies and within the facilities themselves, says Phenelle Segal, RN, president of Infection Control Consulting Services in Delray Beach, Florida.


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ASCs Training Perioperative RNs

Dearth of trained nurses has inspired surgery centers to develop their own programs

Declining numbers of available operating room (OR) nurses have led some ASCs to develop their own perioperative RN training programs. Examples of those programs can be found in Florida Medical Clinic’s two ASCs in Tampa, Florida, and Zephyrhills, Florida, and in the Ambulatory Surgery Center of Niagara in Niagara Falls, New York.


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Fire Safety Compliance

Talk with your patients early to ensure success

William E. Lindeman is the president of WEL Designs PLC of Tucson, Arizona, a consulting firm for health care facility development and regulatory compliance. As a licensed architect working with health care providers since 1983, he has helped plan and design millions of square feet of ASCs, medical practice suites and other facilities.


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Going Out of Network

Benefits and drawbacks

In April, insurance giant Aetna won $37.4 million in a jury verdict against Bay Area Surgical Management (BASM), based in Saratoga, California. The 2012 law suit against BASM alleged that the firm recruited physicians to refer their patients for out-of-network procedures at overblown prices and billed Aetna millions of dollars fraudulently.


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Use Your Anesthesiologists Outside of the OR

Anesthesia can help ASCs overcome common accreditation pitfalls

ASCs looking to improve their accreditation survey performance would be wise to involve anesthesia personnel in the preparation efforts, advises Thomas Wherry, MD, cofounder of Total Anesthesia Solutions, a provider of anesthesia service solutions in Ellicott City, Maryland, and a former surveyor for the Accreditation Association for Ambulatory Health Care.


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Best Practices to Secure Patient Payments

Make your collections efforts successful

Collection from patients will become more challenging as the insurance plans change, says Melodie Garrobo, CASC, administrator for Golden Ridge Surgery Center in Golden, Colorado.

“The patient population became accustomed to coming into a facility, receiving care and worrying about payment later,” she says. “This used to be acceptable with most health care institutions but that was when insurance covered most of the payment. Consumers are moving to high-deductible insurance plans, which means less of the payment comes from insurance and more must come from patients. This is a new world, and ASCs must make patient collections a priority.”


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HIPAA Audits Enter Phase 2

Why that matters

In March, the US Department of Health & Human Services’ Office for Civil Rights (OCR) announced the launch of its next phase of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) audits of covered entities and their business associates. Click here for more information.

“This news should be a wake-up call for ASCs and all health care providers covered under HIPAA to take a close look at what they are doing and have in place concerning HIPAA compliance,” says Lani Dornfeld, head of law firm Brach Eichler’s Palm Beach, Florida, office and a member of the firm’s health law practice group.


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Give the Gift of Health

Join PIH and ASCA to provide surgical services to those in need

Around the world, two billion people lack access to surgical care and many more struggle to find and pay for it, according to an article in the June 2015 issue of The Lancet.

The poorest third of the world’s population receives less than 4 percent of all surgical services, according to a June 2011 World Health Organization report. The impact is devastating on impoverished nations. And every day, Partners In Health (PIH), a global health nonprofit, headquartered in Boston, Massachusetts, strives to fight this tragedy, bringing high-level surgical care where it is most needed—from Haiti to Rwanda and around the world.


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The Joint Commission Opens Advanced Certification Program

The first of its kind for ASCs

The Joint Commission launched its Total Hip and Knee Replacement Advanced Certification Program and began to accept applications from interested facilities on December 17, 2015. On-site reviews started on March 14, says Wendi Roberts, executive director of certification at The Joint Commission. “We are getting applications every week and currently have approximately 15 applications, including one from an ASC [as of April 15, 2016],” she says.


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Leveraging State Association Participation

Use your membership to your benefit

While being a member of ASCA gives an ASC a broadened view of the industry, an understanding of national policies and guidelines and networking benefits on a global scale, being a member of a state association comes with its own set of benefits, says Andrew Weiss, president of the New Jersey Association of Ambulatory Surgery Centers (NJAASC) and administrator of The Endo Center at Voorhees in Voorhees Township, New Jersey.


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Environmental Stewardship in ASCs

Leaner, more efficient practices result in financial savings, improved employee recruitment and retention

An ASC can have a positive impact on its community both inside and outside the facility, environmental experts say.

“It is important for health care providers like ASCs to practice what they preach in terms of embracing the connection between environmental and human health, to promote health and wellness for the people in their community by doing what they can to support a cleaner environment,” says Kaeleigh Sheehan, member engagement manager for Practice Greenhealth, a Reston, Virginia-based nonprofit member organization that provides environmental solutions for the health care sector.


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Becoming the Facility of Choice

Keep your physicians, staff and patients happy

As health care organizations continue to compete for physicians, staff and patients, ASCs need to make themselves the facility of choice or lose to other players in the field, says Kris Sabo, RN, executive director of Pend Oreille Surgery Center in Ponderay, Idaho. “We need to be providing better customer service to our physicians, staff and patients than our competition or we could easily lose them all,” she says.


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ASCA 2016 Convenes in Dallas This Month

Plan now to make the most of the opportunities there

In a year filled with change and uncertainty in health care, ASCA is offering ASC professionals a one-stop shop where they can get everything they need to manage their facility more effectively and make critical decisions that will ensure their ASC’s future success. ASCA 2016, May 19–22, at the Gaylord Texan Resort & Convention Center in Dallas, Texas, is that destination.


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Manage Your Drug Supply

Effective ways to keep on top of shortages and costs

Managing her ASC’s medication inventory is not just an occasional part of the job for Cheryl Ezerskis, CASC, executive director at West Parkway Ambulatory Surgery Center in Pompton Plains, New Jersey. “I spend more time managing our inventory than I care to admit,” she says. “I have to monitor medications every day. Getting the medications we need to do our procedures is a never-ending game I have to play.”


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Drug Diversion

Detection and prevention advice

Drug diversion and poor management of controlled substances in a health care facility can lead to serious consequences. This illegal transfer and use of prescription medicines could result in patient harm and fines and loss of license for an ASC.


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Set Up Your Coder for Success

Find and retain the right match for your ASC

Experts agree that inpatient coding and ASC coding are completely different. Therefore, it would be a mistake to hire an inpatient coder and expect them to code ASC procedures accurately.


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Capital Purchases

Research, analyze and compare before you buy

Acapital purchase mistake can have a significant financial impact on an ASC, says Jennifer Butterfield, RN, CASC, administrator of Lakes Surgery Center in West Bloomfield, Michigan. “Unfortunately, we do not have very deep pockets. If you are going to be taking on the burden of a large purchase and, with it, a large monthly payment, you need to have the cases to justify and then support that payment.”


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Improving the Patient Experience

Follow these ‘Five Habits’

In mid-2014, Deerfield, Illinois-based surgical solutions provider Surgical Care Affiliates (SCA) set out to determine what could be done for every patient to consistently improve the patient experience. To achieve this objective, SCA formed a committee that looked at organizations and companies known for their customer service excellence, including the Cleveland Clinic, Disney and Starbucks.


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Changing Equipment

New payment models promote cost-effective sites of service and patient choice

ASCs have many reasons for replacing one piece of equipment with another. Some are under the ASC’s control, but others are not. Careful planning and the five tips that follow can help ensure that an ASC is buying wisely and help make the changes involved easier for everyone.


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Lowering the Cost of Health Care

New payment models promote cost-effective sites of service and patient choice

As the US health care system continues to look for ways to provide better patient care at a lower price, insurers are exploring innovative payment policies.


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Letting Go

Sound strategies for employee termination

While you might hope that you never need to terminate an employee, ASC leaders always need to be prepared to do so, says Damaris L. Medina, JD, a health care attorney with Michelman & Robinson, LLP, who is based in Los Angeles, California.


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Maximize the Benefits of Quality Improvement Studies

Follow these six easy steps

ASC management experts Kelli McMahan, vice president of operations for Pinnacle III, a Lakewood, Colorado-based ASC development and management company, and Jesseye Arambide, RN, executive director of Oregon Outpatient Surgery Center in Tigard, Oregon, and past president of the Oregon Ambulatory Surgery Center Association, offer advice on ways ASCs can make their quality improvement (QI) studies easier and more valuable.


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Advocacy in Action

Follow an ASC bill on its journey to becoming a law

ASCA and ASCs across the country are on the precipice of a major legislative victory this year: the adoption of the Electronic Health Fairness Act. In 2015, the US House of Representatives and the US Senate unanimously passed slightly different versions of the act which, if enacted, will provide relief to ASC physicians who face penalties due to Medicare’s meaningful use requirements tied to electronic health records (EHR) systems. As this article goes to press, Congress is reconciling the two versions of the bill; the reconciled bill must be passed before it can be signed into law by President Barack Obama.


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Setting the Rules

How the regulatory requirements that apply to your ASC are created and changed

Just as there is a legislative process that all bills must go through to become law [see page 10], there is a regulatory, or rulemaking, process that determines the rules that will be adopted to enforce new laws. Most laws contain language that helps to identify which federal agency will set those rules. Often, the laws also identify specific areas that the rules should address.


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Purchasing an EMR

Do your research before you buy

ASCs have many reasons to purchase an electronic medical records (EMR) system. One is that health care providers of every kind are rapidly adopting electronic records, says Cindy Klein, vice president and chief medical information officer of United Surgical Partners International, an owner, operator and developer of ASCs and short-stay surgical hospitals nationwide based in Addison, Texas.


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Self-Championing Your ASC

Stand up for your center and the work that you do for your community

For more than 40 years, ASCs have provided millions of Americans with high-quality, cost-efficient surgical care, yet many legislators are unaware of their work and how they have transformed the outpatient experience. While ASCA continues to advocate for ASCs and serve as the voice of the ASC community, there is no substitute for individual ASC leaders and staff who lobby their legislators as constituents.


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When a Vendor Files for Bankruptcy

How to handle business with the company going under

Organizations often use bankruptcy as a financial tool to upright their financial stability, says Timothy Walsh, JD, international head of the restructuring and insolvency practice in the law firm of McDermott Will & Emery, who practices out of the firm’s New York office. “All bankruptcy means is your inability to pay your debts as they become due. That is the only requirement you need to be able to file.”


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Consolidation in the ASC Market

To be successful, be proactive in pursuing alignment strategies

Under the federal budget adopted last November, hospitals and health systems are no longer able to buy ASCs, convert them to hospital outpatient departments (HOPD) and charge HOPD prices in those facilities. Even without that option, the trend toward consolidation in the US health care marketplace continues. Many are trying to determine how consolidation is affecting individual ASCs throughout the country, but the only definitive answer seems to be “It depends.”


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The Joint Commission to Launch ASC Program

The agency will roll out its first advanced certification program for surgery centers this year

The Joint Commission is planning the launch of a new product called Total Hip and Knee Replacement Advanced Certification Program this year. The agency has been working with ASCA for the last couple of years to develop this program.


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ASCs Invest More in Benefits, Less in Individual Bonus Pay

ASCA surveys also reveal small salary increases since 2012

ASCs across the country invest more in employee benefits and pay modestly higher salaries to nearly all staff today than in 2012, according to an analysis of data from ASCA’s recently released 2015 ASC Salary and Benefits Survey report and ASCA’s 2012 survey. The analysis also shows that while more ASCs pay bonuses to more staff, the amounts of those bonuses are slightly under those paid in 2012, the last year ASCA conducted its compensation survey. The 2015 survey results, collected from 846 participants, include data on 20 ASC job positions, employee benefits and ASC demographics.


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