AS I SEE IT

Crisis Can Fuel Positive Change

BY CATHLEEN M. MCCABE, MD | OCTOBER 2020

The world has changed rapidly and profoundly for all of us. Every aspect of our lives has been affected by the COVID-19 crisis.

Trends in Colorectal Cancer Screening

BY CINDY YOUNG, RN, CASC | SEPTEMBER 2020

Colorectal cancer, a highly preventable and treatable disease, causes the second highest number of cancer deaths in the US, according to the American Cancer Society.

Options for Controlled Drug Registration

BY SHELDON S. SONES | AUGUST 2020

When an ASC’s controlled drug license is set to expire and requires renewal, the surgery center has options for the go-forward “registrant” designation.

Cut Supply Costs and Help the Environment

BY SCOTT JACKSON AND KEN DIEBNER | JUNE-JULY 2020

Reprocessing single-use devices provides many benefits for ASCs, including cost savings and a reduction of the waste a healthcare facility generates.

Supporting More Complex Orthopedics Cases in the ASC

BY THOMAS PINELLI | MAY 2020

With advances in surgeon technique and surgical equipment, orthopedics cases once performed in the inpatient setting only are safely migrating their way to the outpatient setting. ASCs with orthopedic programs are increasingly performing these more complex cases and for good reasons: Adding such cases can be an effective way to enhance surgical volume while also expanding the types of high-quality, lower-cost cases available for their patient community.

Improve the Patient Experience

BY KYLIE KACZOR AND MICHAEL WINKLEMAN | OCTOBER 2019

Telehealth, wearable health tracking devices, cloud-based services and a seemingly unending list of technological innovations dominate today’s headlines, and all areas of healthcare incorporate technology. Your ASC’s revenue cycle is no exception.

For It Is in Giving that We Receive

BY CATHLEEN MCCABE, MD | AUGUST 2019

When we incorporate the act of giving into the business of our surgery centers and affiliated practices, the positive impacts magnify. Far outweighing the cost of lost chair time for paying patients, involvement in humanitarian activities enhances emotional intelligence, inspires effective teamwork and drives innovation and resourcefulness in your surgical team and the business of ophthalmology.

Stop Guessing, Start Measuring

BY DAREN SMITH | JUNE-JULY 2019

The purposes of quality assurance and performance improvement (QAPI) for ASCs are quite clear. In fact, they are spelled out for you: “quality assurance,” meaning care is maintained at an acceptable level, and “performance improvement,” meaning changes are implemented to strengthen operations.

Trends in Total Joint Replacement

BY AMANDA OLDEROG | MAY 2019

An aging population and high obesity rates continue to increase the prevalence of osteoarthritis and, subsequently, demand for joint replacements. In the next decade Sg2 projects 84 percent growth in hip and knee joint replacement surgery.

Postsurgical Pain Management in ASCs

BY SCOTT A. SIGMAN, MD | FEBRUARY 2019

Major advances in surgical techniques have enabled ASCs to perform a myriad of outpatient surgery procedures on millions of Americans. Many challenges, however, still exist in adequately managing postsurgical pain while minimizing negative outcomes in the ASC setting.

Paving the Way for Bundled Payments

BY CHRIS BISHOP | JANUARY 2019

While movement toward shared savings, shared risk and shared responsibility is paving the way for bundled payments, early adopters in the practice and ASC market have found that moving from concept to execution is extremely complicated.

Relocating Our ASC

BY ROBERT B. NELSON | NOVEMBER-DECEMBER 2018

Relocating an ASC is not easy. I can say this quite confidently as my facility completed a relocation in 2017. It was a substantial amount of work—and this was on top of a tragedy that tested the resolve of our entire staff and demonstrated firsthand the importance of careful planning.

Beware the Changing Reimbursement Landscape

BY KYLIE KACZOR, RN, CASC | OCTOBER 2018

While guidance for licensure proceedings, facility accreditation and Medicare certification is readily available to new ASCs, what ASCs new and old often overlook are the current and pending state regulations and constant shifts in the health care marketplace.

Give the Gift of Surgery

BY CINDY YOUNG, RN, CASC | SEPTEMBER 2018

In March 2018, ASCA invited me to join One World Surgery at its ASC in Honduras to help kick off ASCA’s new scholarship program. The scholarship program is designed to help people who want to go on a medical mission trip but cannot finance the trip on their own. ASCA uses revenue derived from its affinity partners program to fund this scholarship program.

Managing the Disruptive Physician

BY RENA COURTAY, RN, CASC | AUGUST 2018

I have spent the last 28 years working alongside physicians who are, primarily, surgeons. As you can imagine, this experience has provided me with quite a few anecdotes about physician behavior.

Presterilizing Versus Re-Sterilizing Implants and Instruments

BY JOHN WELLS | JUNE-JULY 2018

While single-use equipment is not new in health care, the kinds of instruments and related devices going the route of “one and done” are changing.

Innovations in Ophthalmic Outpatient Surgery

BY MARIA C. SCOTT, MD | MAY 2018

What do ophthalmic surgeons want in an ASC?

We frequently hear this question from ASCs that are considering adding ophthalmic surgery as a specialty.

Maximizing Reimbursements and Compliance

BY JESSICA EDMISTON AND WENDY HORTON | APRIL 2018

Historically, cardiology and vascular procedures were performed exclusively in a hospital setting. Nearly 20 years ago, however, many of these procedures began migrating to outpatient settings, such as renal dialysis centers, catheterization labs and endovascular labs, otherwise known as office-based vascular interventional laboratories (OBLs). The primary drivers for this movement included convenience, shorter appointment wait times and better outcomes for patients; greater control of technology and staffing, plus improved reimbursement, for physician owners of OBLs; and significant cost savings for payers.

Observe National Colorectal Cancer Awareness Month

BY ANN SARIEGO AND LORI TRZCINSKI | MARCH 2018

In February 2000, President Bill Clinton officially dedicated the month of March as National Colorectal Cancer Awareness Month. Since then, it has grown to be a true rallying point for the colon cancer community. Every year, thousands of patients, survivors, caregivers and advocates throughout the community join together to spread colon cancer awareness by wearing blue, holding fundraising and educational events, and talking to friends and family about screening.

Ins and Outs of H&P

BY DEBRA STINCHCOMB AND REGINA BOORE | OCTOBER 2017

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).

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).

Patient Safety, It Is Everyone’s Job

BY ANN GEIER, RN, CASC | JUNE-JULY 2017

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.

The Complex Case Conundrum

BY LINDSAY MCQUEENEY HANRAHAN | APRIL 2017

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.

The Value Proposition for ASCs

BY TERRY BOHLKE, CASC, AND BRANDON FAZIO | JANUARY 2017

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.

Use Data to Your Advantage

BY NADER SAMII | OCTOBER 2016

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.

Running an Effective Board Meeting

BY TERRY BOHLKE, CASC, AND COLIN RORRIE | AUGUST 2016

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.

Breast Cancer Surgery in the ASC Setting

BY MICHAEL J. CROSS, MD, AND DAWN ASHBY, RN, CASC | MAY 2016

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.

CPT Coding Change

BY JESSICA EDMISTON AND TAMARA WAGNER | APRIL 2016

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.

Leadership Development in the ASC

BY TERRY BOHLKE, CASC | MARCH 2016

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.

Industry Outlook

BY TERRY BOHLKE | JANUARY 2016

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.

As I See It

AS I SEE IT