Message from the President

Infection Prevention in Your ASC

Observations have shown that surgical site infections (SSI) rarely happen because of a single cause; multiple breaches cause SSIs. ASCs have an excellent track record in infection prevention, but it never hurts to revisit the issue.

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Message from the CEO

ASCA Stands By Its Members

In 2023, as the number of ASCs in the US rose, growing numbers of patients, physicians and payers continued to seek the many benefits ASCs provide. Meanwhile, surgery centers faced worker shortages, supply chain disruptions and rising costs that sometimes threatened their ability to serve patients.

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As I See It

Adding Anesthesia as an Ancillary Service

Learn how ASCs make this idea work

As executive vice president of Anesthesia Operations at nimble solutions, I have noticed a growing trend among ASCs and anesthesia providers. Typically, anesthesiologists establish third-party contracts with ASCs. Recently, however, ASCs have begun to embrace anesthesia as an ancillary service.

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Doing Business

Best Practices in Sterile Processing

Training, testing and proper PPE use are essential

The sterile processing department (SPD) plays a crucial role in maintaining a clean and sanitary environment within a surgery center. Decontamination, cleaning, washing, inspecting, sterilizing and testing are just some of the tasks staff perform there.

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Emergency Preparedness

Shootings in Healthcare Facilities Rise

Steps to take to keep your surgery center safe

The topic of emergency preparedness comes up regularly in workplaces, but recently, this preparation has had to be enhanced. Specifically, healthcare facilities now have to think about what to do in the case of an active shooter.

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ASCA Members Celebrate National ASC Month

Surgery centers host facility tours for congressional staff, advocate for their cause

In August, ASCs across the country celebrate National ASC Month to highlight the high-quality, cost-effective surgical care that surgery centers provide to their patients and communities. 90210 Surgery Medical Center in Beverly Hills, California, and South Kansas City Surgicenter in Overland Park, Kansas, hosted their members of Congress to educate them about ASCs and the work they do for their community.

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Sg2 2023 Annual Report Forecasts Significant Growth in ASC Volume

GI, ophthalmology and orthopedic procedures will see the highest increases

ASCs will see 12 percent and 22 percent growth in the next 5 and 10 years, respectively, according to Sg2’s 2023 Impact of Change Forecast Highlights.

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Master Life Safety Code Compliance

Sign up for ASCA’s virtual course this October to learn how

ASCA’s third virtual course this year, Life Safety Code for ASCs, will be broadcast live over two half days, October 23 and 24. Recordings of the sessions will be available on demand later.

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Bryant Receives Nap Gary Award for Lifetime Achievement

The former chief executive officer of ASCA led the organization from 1998–2010

ASCA awarded its 2023 Nap Gary Legacy Award for Lifetime Achievement in the ASC Community to Kathy Bryant, former chief executive officer of ASCA.

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Doing Right by the Community

An Illinois ASC helps patients in need access care

The Orthopaedic Institute Surgery Center in Metropolis, Illinois, helps its community by never sending a child who needs surgery back home without that surgery if the ASC can safely provide it. This is irrespective of the child’s insurance status. Melanie Russell, RN, the administrator of the ASC, is a pivotal part of this effort.

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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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South Carolina Enacts Major Reform to Certificate of Need Law

Changes eliminate CON requirements for new ASCs

South Carolina Governor Henry McMaster signed SB 164 in the spring, eliminating certificate of need (CON) requirements for almost all health facilities, including ASCs, in the state, but excluding nursing homes and the Medical University of South Carolina.

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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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Reintroducing the ASC Act in Congress

If passed, the Outpatient Surgery Quality and Access Act will better align Medicare’s ASC and HOPD payment systems

As this issue of ASC Focus goes to press, Congressman John Larson (D-CT) and Congressman Brad Wenstrup, DPM (R-OH), are planning to introduce the Outpatient Surgery Quality and Access Act of 2023 in the House side of the 118th Congress, and Senator Richard Blumenthal (D-CT) and Senator William Cassidy, MD (R-LA), are planning to introduce the legislation in the Senate.

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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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Exploring Denial Reasons

A revenue cycle analysis

With a focus on improving surgery centers’ revenue cycle management operations and rate of collections, our business intelligence and analysis team recently conducted a study using a subset of data to investigate common denial reasons for ASCs.

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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

Patient Experience Survey to Become Mandatory Soon

Now is the time to start working on implementation

The Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) Survey will become a mandatory component of the ASC Quality Reporting (ASCQR) Program in 2025. Facilities should start the process of selecting a vendor now to ensure they are able to meet this deadline.

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Advocacy Spotlight

Surgical Smoke Evacuation Laws Spread across the Country

Thirteen states have created new requirements since 2018

Missouri became the latest state to join a growing number of states with surgical smoke evacuation requirements when Missouri Governor Mike Parson signed HB 402 into law last summer, enacting surgical smoke evacuation requirements for ASCs and hospitals. Primarily pushed at the state level by the Association of periOperative Registered Nurses (AORN), the issue has seen sustained interest since Rhode Island enacted the first requirement in 2018.

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Member Profile

Tammeria Tyler, RN, CAIP

Tammeria Tyler, RN, CAIP, an infection preventionist at Southeastern Spine Institute Ambulatory Surgery Center in Mount Pleasant, South Carolina, discusses the evolution of infection prevention in ASCs.

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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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Renew Your Membership for 2024

Thank you for being an ASCA member in 2023. Your dues dollars support the critical advocacy and public information campaigns ASCA conducts on your behalf and give you access to a valuable array of benefits that can help you improve the performance of your ASC.

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Web Crawl

Register for ASCA 2024

Register today for the ASCA 2024 Conference & Expo, April 17–20, at the Gaylord Palms Resort & Convention Center in Kissimmee, Florida.

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