Message from the President

March of Technology in ASCs

Over the course of my career working in ASCs, it’s been hard not to marvel at the extraordinary advances in technology that have affected and improved everything from front office administration to the equipment and devices that make up the modern surgical suite.

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Message from the CEO

Take Advantage of ASCA’s Educational Opportunities

Did you know that three-quarters of the ASCs that failed to meet the Centers for Medicare & Medicaid Services’ quality reporting requirements in 2022 were not ASCA members? ASCA has resources that can help your surgery center meet Medicare’s quality reporting requirements and comply with other regulatory requirements that apply.

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ASCA 2024

Maintain Sound Mental Health in the Workplace

Join your peers at ASCA 2024 to learn how

Our own well-being and the well-being of all the employees in our surgery centers holds immense importance. Mental health in the workplace isn’t merely about the absence of illness; it encompasses emotional resilience, psychological well-being and the capacity to navigate daily challenges effectively.

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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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Decoding the Anatomy of Pain Management Injections

Epidurals, biologics and emerging technologies

Understanding patient anatomy is a crucial part of the coding process, especially for intricate procedures like pain management injections. Getting those codes right the first time requires comprehensive knowledge of each injection type, technique and administration site.

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How to Use CMS’ Single-Use Endoscopes Billing Code

Follow these tips

The Centers for Medicare & Medicaid Services recently assigned a new Healthcare Common Procedure Coding System (HCPCS) code for use in facility billing for single-use endoscopes. This device code offers ASCs additional Medicare payments when using disposable ureteroscopes.

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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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The Future of ASCs

Advancing health equity through technology

“Health equity” is the state in which everyone has a fair and just opportunity to attain their highest level of health. Throughout my years as a surgeon and a national manager of surgery centers, I witnessed a transformation in the American healthcare landscape. Driven by the ASC industry, this transformation led and inspired improvements in efficiency and enhanced healthcare quality.

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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

Update on No Surprises Act

Critical questions remain in year three

In December 2020, then President Donald J. Trump signed the Consolidated Appropriations Act, 2021 (CAA) into law. Included in the 1,067-page bill was Section BB, Title I, the No Surprises Act (NSA), which established new protections for patients against surprise bills in certain emergency and nonemergency situations.

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Advocacy Spotlight

Indiana Senator Cosponsors ASC Quality and Access Bill

Senator Mike Braun recognizes the essential role of surgery centers in the US healthcare system

Senator Mike Braun (R-IN), a leading voice in the Senate Health, Education, Labor and Pensions (HELP) Committee, is a strong advocate for ASCs. He has a small business background, understands the challenges surgery centers face and is committed to “fixing our broken healthcare system and strengthening workforce development.”

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Member Profile

Elisa Auguste, CASC

Elisa Auguste, CASC, administrator of Precision Care Surgery Center in Setauket, New York, and board member of the New York State Association of Ambulatory Surgery Centers in Albany, New York, shares tips on using clinical technology effectively in the 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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There’s Still Time to Register for ASCA 2024

Registration is still open for the ASCA 2024 Conference & Expo, taking place this month, April 17–20, in Orlando, Florida. Get access to top-quality clinical, regulatory, business and financial information and advice from many of the best and most experienced professionals in the ASC community.

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Web Crawl

Benchmarking Q1 Data Submission Begins April 1

The data submission period for the first quarter (Q1) of ASCA’s 2024 Clinical & Operational Benchmarking Survey opens April 1.

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