Message from the President

Using New Technology Wisely

Advancements in technology are transforming healthcare, but what exactly is healthcare technology and how is it affecting ASCs? The World Health Organization defines health technology as the application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives.

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Message from the CEO

See You at ASCA 2023

By the time you receive this magazine, ASCA staff will be busy putting the final touches on the ASCA 2023 Conference & Expo, May 17–20, in the charming city of Louisville at the Kentucky International Convention Center (KICC), working to make sure everyone who attends has a great experience.

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ASCA 2023

Are You Survey Ready?

Come to ASCA 2023 to learn how to be prepared for AAAHC accreditation

Preparing for any type of survey can be a difficult process. During my joint presentation with Jan Kleinhesselink, RN, “Preparing for AAAHC Accreditation,” at the ASCA 2023 Conference & Expo, May 17–20, in Louisville, Kentucky, we will discuss the mechanics of applying for your Accreditation Association for Ambulatory Health Care survey, what you can expect during the survey, and how to get ready for it.

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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

Leveraging Culture to Combat Labor Issues

Key drivers of success

Persistent labor issues continue to pose financial and operational challenges for surgery centers. The rising costs to staff cases combined with the inability to operate at full surgical capacity is a one-two punch that is expected to cause damage throughout 2023 and beyond.

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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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New Faces in the 118th Congress

Committees of jurisdiction now have different members

With the start of the 118th Congress, ASCA will continue to focus its legislative efforts and meetings on connecting with representatives and senators who serve on the committees to which legislation of interest to the ASC community would be referred upon introduction. These are known as committees of jurisdiction.

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New Research Shows Rapid Shift of Total Joint Surgeries to Outpatient

Even though the uptick in the move coincides with the pandemic, study authors say the change is permanent

Thanks to advancements in medical techniques and devices, surgeons are performing an increasing number of total joint surgeries in the outpatient setting.

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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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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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Hackers Continue to Breach PHI

What ASCs can do to keep their data safe

Healthcare organizations across the country posted 333 breaches of protected health information (PHI) affecting 500 or more individuals in the last half of 2022, the latest data available on the matter. Consistent with previous time periods, the vast majority of the breaches—95 percent—were caused by unauthorized access or hacking.

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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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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

Medicare Reimbursement Policy Impedes Migration to ASC Setting

ASCA advocates for elimination of ASC weight scalar

ASCs saved the Medicare program more than $5 billion in 2021, and according to a 2020 study by ASCA and KNG Health Consulting LLC, absent any major policy changes, ASCs are already expected to provide more than $10 billion in annual savings to Medicare by 2027. Researchers assert that “policymakers can further offset the expected growth in Part B payments to hospitals by prioritizing payment policies that encourage the migration of procedures to the lower-cost ASC setting.”

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Advocacy Spotlight

ASC Advocates Return to Capitol Hill during National Advocacy Day

Participants represented 31 states and met with more than 100 members of Congress and their staff

Linda Bedwell, RN, CASC, director of Powder River Surgery Center in Gillette, Wyoming, recently participated in ASCA’s first in-person National Advocacy Day in more than three years.

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Member Profile

Tamala Norris, RN

Tamala Norris, RN, chief nursing officer and vice president of clinical operations for United Surgical Partners International in Dallas, Texas, discusses her company’s DEI initiatives and their goals.

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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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Attend June and July Webinars

ASCA will host two webinars in June and July, one on the importance of physician engagement in the ASC setting and the other on how to identify appropriate software and technology to support operational efficiency.

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Web Crawl

Q2 Benchmarking Data Submission Opens in July

Data submission for the second quarter (Q2) of ASCA’s 2023 Clinical & Operational Benchmarking Survey will be open July 1–31.

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