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Bohlke Joins HOP

Panel advises CMS on ASC payment system

BY SAHELY MUKERJI | MARCH 2019

Terry Bohlke

Last week, the Hospital and Ambulatory Policy Group of the Centers for Medicare & Medicaid Services (CMS) invited Terry Bohlke, former president of the ASCA Board and vice president of Ambulatory Surgery Centers at Community Health Systems in Franklin, Tennessee, to serve on the Advisory Panel on Hospital Outpatient Payment (HOP).

“I am so honored to be selected for the advisory panel,” Bohlke says. “With so much of healthcare moving to the outpatient setting, it is essential regulations stay abreast of these trends, while always ensuring patient safety for the populations served by CMS programs.”

The HOP panel advises CMS on the ambulatory payment classifications (APC) groupings and weights, which are the basis of the ASC payment system. This includes the OPPS rates for ASC procedures, review of the inpatient only list and other technical issues regarding APCs.

“With my background in hospital and ASC management, I hope to add a new voice to the conversation,” Bohlke says. “The panel also advises on the appropriate supervision level for hospital outpatient services to ensure an appropriate level of quality and safety, and I very much look forward to being a part of this important process.”

The HOP panel is a 15-member team that helps determine payment policies for both hospital outpatient departments (HOPD) and ASCs. Currently, statute requires all HOP members be employed by a hospital or health system.

Ensuring that the HOP panel includes at least one representative of the ASC industry was a provision of the ASC Payment Transparency Act of 2018 that the US House of Representatives passed in July 2018. This legislation also requires CMS to disclose the criteria used to determine the ASC procedure list.

“This is a significant step for ASCs," says Bill Prentice, CEO of ASCA. "Having a representative on the HOP panel with ASC experience will assure that the ASC voice is heard when CMS considers changes to that payment system. And Terry, with his hospital and ASC work experience, is the best candidate for the position.”