Message from the President

ASCA Forms DEI Task Force

Last year, at our spring meeting, members of the ASCA Board of Directors approved a resolution to create a volunteer task force within ASCA to address issues related to diversity, equity and inclusion (DEI) in the ASC community. Since then, we have recruited 12 ASCA members who have volunteered to look at employment in the ASC industry, the diversity of our patient population and the ways in which we can improve our cultural competencies as healthcare providers. Our goal is to have recommendations ready for the ASCA Board and ASCA members at the annual conference in May.

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Message from the CEO

Renew Your Membership, Help ASCA Work for Your ASC

ASCA members often tell us that the end of the year is their busiest time of year. As you are closing your books, checking off the items on your end-of-year lists, accommodating staff holiday plans and providing procedures to high numbers of patients seeking care before their deductibles reset, it is hard to add more to your already full plate. However, if you have not already renewed your ASCA membership, I encourage you to renew it now.

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As I See It

Market-Specific Factors Drive ASC Strategy

Surgical volume shuffle across ambulatory sites will continue throughout the decade

Each year, Sg2 debuts the latest healthcare projections from our 10-year Impact of Change (IoC) national demand forecast. This year’s forecast is influenced by trends seen over the past two years, with significant changes in utilization, care delivery models and site-of-care shifts across the care continuum.

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Doing Business

Create an Experience that Employees Prefer and Patients Want

Technology could streamline processes

In the early 1900s, Frederick Winslow Taylor penned the famous Principles of Scientific Management Theory. In it, he described how to optimize the way work gets done and studied the tiniest of tasks, leading to the division of labor and establishment of rigorous processes and hierarchy.

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ASCA 2023

Become an ASC Advocate in Your State

Attend ASCA 2023 to find out how

Getting involved in government affairs and advocating on behalf of your ASC can seem like a daunting task. After all, so much of your time and energy are already committed to keeping your facility running smoothly, and meeting and engaging with elected officials can seem intimidating.

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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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Sg2 Annual Report Projects Double-Digit ASC Growth

Expansion expected in nearly all major specialties

ASCs will see 15 percent and 25 percent growth in the next 5 and 10 years, respectively, according to Sg2’s 2022 Impact of Change Forecast Highlights.

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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

Bundling Care

An ASC director of operations discusses value-based payments in her surgery center

Becky Ziegler-Otis, CASC, ASCA Board member and director of operations for revenue cycle at Ambulatory Surgical Center of Stevens Point in Stevens Point, Wisconsin, recently talked with ASC Focus about how the center’s prior experience with bundled payments helped prepare it to participate in WC Bundled Payments, Trilogy Health Solutions’ workers’ compensation cost-containment program.

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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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Eliminate Common ASC Coding and Billing Compliance Issues

Follow these steps

Noncompliant coding and billing can lead to increased denials, missed reimbursement opportunities and unnecessary refunds. Additionally, poor compliance outcomes harm surgeon and patient satisfaction and could lead to more serious consequences, including loss of payer contracts and legal ramifications.

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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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Review Key Revenue Cycle Metrics as Your ASC Grows

Consider improving processes in these four areas as your center adds more complex procedures to its list

Driven by continuous successful outcomes in the outpatient setting, ASCs have emphasized incorporating more complex procedures into their repertoires as a formative growth strategy.

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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

Analyzing CMS’ 2023 Final Medicare Payment Rule; Looking Ahead to 2024

Positive developments in 2023, but much work lies ahead

In its 2023 final payment rule for ASCs and hospital outpatient departments (HOPD), the Centers for Medicare & Medicaid Services (CMS) showed a willingness to advance policies that will drive volume to the ASC setting and save Medicare and its beneficiaries money.

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Advocacy Spotlight

Four State Associations Score Important Policy Wins in 2022

Connecticut and Pennsylvania secure changes while Massachusetts and Washington stave off negative legislation

As the COVID-19 pandemic faded from state legislative agendas, state legislatures in 2022 turned back to regular business, including core issues affecting ASC operations.

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Member Profile

Melissa Hermanson, RN, CASC

Melissa Hermanson, RN, CASC, administrator of Ambulatory Care Center in Vineland, New Jersey, discusses her best strategies for marketing an ASC.

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Industry Insight

William A. Miller

William A. Miller, partner at Higgs, Fletcher, & Mack LLP in San Diego, California, discusses the most important legal issues for ASCs this year.

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Register for ASCA 2023 and Save

Make sure your ASC is at the front of the pack in 2023 and beyond. Reserve your spot now at the ASCA 2023 Conference & Expo, taking place in person May 17–20, in Louisville, Kentucky.

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Web Crawl

Renew Your Membership for 2023

Make sure your ASCA membership is current to continue receiving this magazine and all your member benefits in 2023.

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