The year has almost come to a close. Here are 202 notable ambulatory surgery center and healthcare industry updates from over the course of 2014.
ASC company news
1. AmSurg shares rise in value after Sheridan deal announcement.
Raymond James analyst John Ransom set AmSurg's price target at $60 and upgraded his recommendation to buy. The upgrade was made closely following AmSurg's announcement of intention to acquire Sheridan Healthcare for $2.35 billion
2. AmSurg completes Sheridan acquisition.
AmSurg announced in May intent to acquire anesthesia provider Sheridan for $2.35 billion. Now, the company has officially completed the transaction.
3. AmSurg reports Q1 earnings.
AmSurg net earnings from continuing operations attributable to common shareholders were $17.5 million in the first quarter of 2014. The company reportedly operated 242 centers at the end of the quarter.
4. AmSurg reports Q2 financial results.
AmSurg revenues rose to $281.1 million, up 5 percent from $267.1 million in the second quarter of 2013. Net earnings attributable to common shareholders were $19 million, or $0.59 per diluted share, up from $18.4 million, or $0.58 per diluted share, in the same period last year.
5. AmSurg 3Q revenue nearly doubles.
AmSurg's net reaffirmed were $503.2 million, up 91.3 percent from the third quarter of 2013. The company also exhibited 110.4 percent growth in adjusted EBITDA to $95.9 million. The company's net loss from continuing operations was $12.1 million; adjusted net earnings were $34.6 million, up 92.4 percent.
6. Hospital Corporation of America expects $35.5B in 2014 revenue.
Hospital Corporation of America reaffirmed its guidance ranges for 2014, which included revenue of $35.5 billion and adjusted EBITDA of $6.6 billion on the low ends. As of March 31, HCA operated 115 ambulatory surgery centers.
7. Hospital Corporation of America Q2 revenue rises 9%.
Hospital Corporation of America expects revenues from the second quarter of this year will be $9.23 billion, up 9 percent from $8.45 billion in the second quarter of last year.
8. HCA reports $9.22B in Q3 revenue.
HCA reported revenues of $9.22 billion in the third quarter of 2014, up 9 percent from $8.46 billion in the prior year's period. HCA had $518 million in net income from the quarter, up from $365 million in the third quarter of 2013.
9. Foundation Healthcare revenue jumps 18% in Q1.
Foundation Healthcare reported $22.1 million in revenue for the first quarter of 2014, up 18 percent from $18.7 million in the first quarter of 2013.
10. Foundation Healthcare patient services revenue rises 7%.
Foundation Healthcare patient services revenue increased 7 percent from the second quarter of 2013 to $19.9 million. The company reported $22.1 million in net revenue for the quarter, a 2 percent increase from $21.6 million in the second quarter of 2013.
11. Foundation Healthcare Q3 revenue jumps 16%.
Foundation HealthCare reported $27.4 million in revenue for the quarter, up 16 percent from the third quarter of 2013. The company's adjusted EBITDA was $3.5 million, up 26 percent from $2.8 million in the prior year's period.
12. Laser Spine Institute to build $56M HQ, ASC.
Laser Spine Institute is building new headquarters and an ASC, which will cost approximately $56 million, in Tampa, Fla. The 176,000-square-foot facility is expected to create 100 jobs and increase patient capacity by 25 percent. LSI plans on beginning construction this fall and it is slated to be complete by 2016.
13. Medical Facilities Corporation reports Q1 financial results.
Medical Facilities Corporation reported $72.9 million in first quarter 2014 revenue, which is consistent with revenue reported in the first quarter of 2013.
14. MFC reports slight bump in Q2 revenue.
Revenue for the second quarter was $74.4 million, a slight increase of 0.9 percent from $73.7 million in the second quarter of 2013. Income from operations was down 2.5 percent from $20.8 million last year to $20.3 million.
15. MFC's Q3 revenue increases 5.5%.
MFC's consolidated facility service revenue was $77 million, up 5.5 percent from $73 million in the third quarter of 2013.The company's consolidated income from operations was up 6.2 percent from $20.1 million in 2013 to $21.3 million in the third quarter of this year.
16. Northstar Healthcare reports Q1, Q2 financial results.
Northstar Healthcare reported first quarter 2014 net patient service revenue of $121.1 million, up 194.1 percent from $4.1 million in the first quarter of 2013. For its second quarter, the company reported $15.1 million in estimated revenue.
17. Northstar Healthcare 3Q revenue up 125%.
Northstar Healthcare reported its third quarter financial results. The company reported $17.2 million in net patient service revenue, up 125 percent from $7.6 million in the third quarter of 2013. Northstar reported 1,649 cases for the quarter, up 22.7 percent from the 1,344 cases performed in the prior year's period
18. Northstar Healthcare reorganizes leadership.
Northstar Healthcare appointed Harry Fleming, MBA, as its president. Mr. Fleming was previously CFO. Vice president of finance Andy Chen will now step into the CFO role.
19. Northstar Healthcare to list shares on U.S. exchange.
Northstar Healthcare has filed a Form 10 Registration Statement with the U.S. Securities and Exchange Commission. The filing was made in preparation for Northstar common shares to be listed on a U.S. national exchange.
20. Northstar Healthcare to form new business entity with First Surgical Partners.
Northstar Healthcare has reached an agreement with First Surgical Partners to form a new business entity, which will own and operate First Street Hospital and First Street Surgical Center, both in Houston. Northstar Healthcare will own 51 percent of the new entity, while First Surgical Partners will own the remaining stake. Northstar will contribute $7.5 million to the new entity.
21. Northstar Healthcare rebrands as Nobilis Health.
Earlier this month, Northstar Healthcare acquired marketing company Athas Health for $34 million. Following the acquisition, the company rebranded as Nobilis Health. Christopher Lloyd of Athas Health assumed the role CEO for the combined companies.
22. Nueterra creates new approach to patient satisfaction.
Nueterra launched a new program to improve patient satisfaction scores at its surgery centers. Riddle Surgical Center is one of the first centers to take on the pilot program, which involves observation of patient and staff interaction and listening exercise to improve communication.
23. Outpatient facility stocks have an edge.
In a post from a Zacks Investment Research blog, the firm is supporting outpatient facility stock. The post also promoted AmSurg as a stock with a "good Zacks rank," potential to grow in the current healthcare environment and as a "good addition" to your portfolio.
24. Regent Surgical Health launches revenue cycle management service.
Ambulatory surgery center management and development company Regent Surgical Health has officially launched a revenue cycle management service. The service focuses on optimizing ASC billing and collections workflow, as well as generating metrics to analyze and improve ASC financial health.
25. Regent Surgical Health opens new joint venture ASC.
Regent Surgical Health, a group of physicians and Providence Health & Services opened a joint venture ASC on the Providence Portland (Ore.) Medical Center campus.
26. SCA reports Q1 financial results.
For the first quarter of 2014, Surgical Care Affiliates reported that total net operating revenues, excluding facilities in which the company does not own a controlling interest, increased 2.1 percent from $192 million to $196 million.
27. SCA Q2 revenue up 10%.
Total net operating revenues, excluding revenues from centers in which SCA does not hold a controlling interest, rose 8 percent from $196.7 million in the second quarter of 2013 to $212.4 million. System-wide revenue, including all centers in which the company has an interest or manages, rose 10.2 percent.
28. SCA Q3 revenue rises 13.1%.
Surgical Care Affiliates announced its financial results for the third quarter of 2014. SCA's total net operating revenue, excluding facilities in which the company owns a non-controlling interest, increased 13.1 percent, from $194.4 million in the third quarter of 2013 to $219.9 million. Net operating revenue including all facilities in which the company owns an interest rose 10.5 percent from the same period last year.
29. USC affiliates with SCA.
Los Angeles County-USC Medical Center has formed a strategic alliance with Surgical Care Affiliates to manage several of its surgery centers. SCA will take over management of USC Surgery Center-Glendale (Calif.), with USC surgeons continuing to staff the center.
30. Physicians, SCA to open Greater Long Beach Endoscopy Center.
Developers broke ground on the 90,000-square-foot Douglas Park Medical Office Park in Long Beach, Calif. One of the new medical office buildings will be occupied by physicians of Long Beach Gastroenterology. The physicians will operate the Greater Long Beach Endoscopy Center, affiliated with Surgical Care Affiliates.
31. SCA, DISC Sports & Spine form joint venture.
Surgical Care Affiliates and Newport Beach, Calif.-based DISC Sports & Spine have formed a joint venture. The goals of the joint venture are to "elevate the quality of outpatient surgery, increase accountability and reduce costs to consumers," according to a news release.
32. Physicians Endoscopy to open North Carolina center.
Physicians Endoscopy and a group of five gastroenterologists will open the Greater Gaston Center in Gastonia, N.C., this year. The center is finally opening after the North Carolina Court of Appeals denied CaroMont Health's effort to object to the project.
33. Physicians Endoscopy opens New York endoscopy center.
Physicians Endoscopy and five physicians opened Island Digestive Health Center in West Islip, N.Y.
34. Surgery center company settles false claims suit.
National outpatient ambulatory surgery center operator Meridian Surgical Partners settled a qui tam lawsuit brought by a former employee at one of its centers. Trial was set to begin in this case on September 23, 2014. Meridian Surgical Partners did not admit any wrongdoing. "While the allegations in the lawsuit were completely without merit, we chose to settle this action to avoid the financial costs and distractions that would have come with further legal proceedings," said John Wilson, CEO of Meridian.
35. Surgery Partners to acquire Symbion for $792M.
Surgery Partners will acquire Symbion for $792 million. Symbion is currently owned by private equity firm Crestview Partners. After the close of the deal, Surgery Partners will operate 100 facilities in 27 states.
36. Surgery Center Holdings' debt-to-EBITDA ratio to rise post-Symbion acquisition.
Moody's Investors Service expects Surgery Center Holding's debt-to-EBITDA ratio to rise eight-fold following its $792 million acquisition of Symbion. Moody's also reports the company has no capital left from H.I.G.'s initial investment, following Symbion's acquisition and two dividend recaps.
37. Surgery Partners closes Symbion acquisition.
Surgery Partners, a portfolio company of H.I.G. Capital, completed the $792 million acquisition of Symbion. The now combined businesses are expected to generate more than $900 million in annual revenues.
38. Surgery Partners to divest ASC in FTC settlement.
The Surgery Partners acquisition of Symbion has closed, but as required by the Federal Trade Commission, Surgery Partners will divest Blue Springs Surgery Center in Orange City, Fla. The Surgery Partners-Symbion deal would have consolidated ownership of the only two multispecialty ASCs in Orange City, the root of the FTC complaint.
39. Symbion reports $133.9M in Q1 revenue.
Symbion released its first quarter 2014 financial results. The company reported $133.97 million in revenue compared to $130.38 million in the first quarter of 2013. Operating income was $21.34 million, up 3.8 percent from $20.56 million in the first quarter of 2013.
40. Symbion Q2 revenue rises 7%.
Symbion reported $142.2 million in revenue for the second quarter of 2014, up 7.5 percent from $132.3 million in the second quarter of 2013. Symbion ended the quarter with $6.6 million in net income, up from $1.5 million in the second quarter of 2013. Symbion's case volume dipped slightly from 55,384 cases performed in the second quarter of 2013 to 55,242 cases. But, patient services revenues grew from $131 million in the year prior to $140.8 million.
41. USPI reports Q1 financial results.
United Surgical Partners International reported consolidated net revenues of $145.3 million for the first quarter of 2014, compared to $145.1 million during the same period in 2013. The company acquired two facilities in the first quarter.
42. USPI Q2 operating income up 18%.
Operating income, $60.6 million in the second quarter of 2013, rose 18 percent to $71.7 million. Net revenues increased to $161.1 million, up 4 percent from $155.2 million in the prior year. EBITDA less noncontrolling interest grew to $58.1 million, up 5 percent from $55.2 million in the second quarter of 2013. USPI's cash flows for the second quarter were $44.9 million compared to $38.9 million in the same period last year.
43. USPI reports Q3 financial results.
USPI reported $159.2 million in net revenues for the third quarter, up 5 percent from $151 million in the previous year's period. The company's operating income was $64.4 million, up 2 percent from $63.1 million. The company's cash flow from operating activities was $53.9 million, up from $50.7 million in the third quarter of 2013.
44. USPI, Mnet Financial partner for patient payment.
Mnet Financial created a co-insurance payment program for United Surgical Partners International to provide patients with payment plans for their medical bills. USPI patients will have access to flexible payment plans without interest through Mnet Financial's MedDraft payment plan management system.
45. Mercy Medical Center, USPI acquire ownership in Siouxland Surgery Center.
Mercy Medical Center Sioux City and United Surgical Partners International have partnered to acquire a majority interest in Siouxland Surgery Center in Dakota Dunes (S.D.). The new partnership is designed to meet the needs of a growing community.
46. USPI acquires majority interest in Somerset ASC.
In April, United Surgical Partners International acquired a 55 percent interest in Somerset Ambulatory Surgery Center in Somerville, N.J. SASC is a multispecialty, two-operating room surgery center with more than 20 physician owners.
General healthcare news
47. Healthcare adds 29k jobs in November
The healthcare industry contributed 29,000 of the overall 321,000 new jobs that were added in the United States in November 2014. Read the full report on Becker's Hospital Review.
48. U.S. leads world in health spending per capita.
In 2012, the United States spent $8,745 in health expenditure per capita. Norway came in second with $6,140 per capita in healthcare spending. Belgium was the last of the top 10 spenders with $4,419 per capita.
49. CBO: national healthcare spending to increase to 22% of GDP by 2038.
The Congressional Budget Office's 2013 long-term budget outlook report predicts that national healthcare spending will increase to 22 percent of the gross domestic product by 2038 under current law.
50. Healthcare spending grows 9.9% in first quarter.
Healthcare spending grew 9.9 percent year-over-year in the first quarter of 2014, according to data released by the Bureau of Economic Analysis.
51. Healthcare spending expected to grow over next decade.
Healthcare spending is expected to increase to 5.6 percent in 2014 and 6 percent per year from 2015 to 2023, according to a recent report from CMS' Office of the Actuary published in Health Affairs.
52. Healthcare M&A spending rises 152% in Q2.
Healthcare merger and acquisition spending rose to $135.2 billion in the second quarter of this year, a 152 percent increase from the same period in 2013.
https://www.beckershospitalreview.com/hospital-transactions-and-valuation/healthcare-m-a-spending-skyrockets-152-in-q2.html
53. Mergers may contribute to rising healthcare costs.
A report published in The Wall Street Journal suggests that the increase in hospital and health system mergers may be a significant cause of rising healthcare costs. Across the country, private insurance payments to hospitals have risen 3 percent due to consolidation, according to a 2012 Catalyst for Payment Reform report.
54. New study questions economic logic beyond CON law.
A recent study from the economic research nonprofit Mercatus Center at George Mason University challenges the economic logic behind certificates of need. The CON study analyzed data on CONs, healthcare productivity and economic impact from the Healthcare Cost Report Information System, American Hospital Association and American Health Planning Association.
55. Hospital ownership increases physician spending by 20%.
Hospital-owned physician practices spent up to 20 percent more per patient annually than physician-owned groups in California. The study was conducted by James Robinson, PhD, a professor of health economics at the University of California Berkley's School of Public Health, and Kelly Miller, a program analyst at the Integrated Healthcare Association in Oakland, Calif.
56. Physician, clinical services spending to grow 5.9%.
Expenditure growth for physician and clinical services is projected to accelerate to 5.9 percent this year, compared with 3.3 percent in 2013. The acceleration in expenditure growth for physician and clinical services in 2014 is influenced by expectations the newly insured will be younger than those who are currently insured.
57. Employer healthcare costs to rise 5.5%.
Worker premiums and out-of-pocket costs have doubled since 2009 and continue to rise. Annual employer healthcare costs will rise 5.5 percent in 2015 from $10,717 to $11,304, the highest percentage rate increase since 2011 when employer costs rose 8.5 percent.
58. Healthcare costs number one concern for employers.
Only 45 percent of small and mid-sized business executives say they are ready for the employer mandate implementation under the Patient Protection and Affordable Care Act, according to a recent survey conducted by the Lucas Group. The employer mandate will become effective in 2015 and requires businesses with more than 50 employees to provide healthcare coverage or be subject to fines. Read the full report on Becker’s Hospital Review.
59. 19% of 2015 private health insurance spending to go towards outpatient services.
A PwC Health Research Institute report projects 19 percent of total private health insurance spending will go towards outpatient services. The top spending groups, inpatient services and professional services, claim 31 percent each.
60. Inpatient utilization decline expected to continue.
As outpatient volumes continue to grow, inpatient utilization continues to drop. Sixty-three percent of surveyed executives expect a decrease in inpatient admissions over the next five years. Read the full report on Becker's ASC Review.
61. California cities lead country in cost of primary care.
A Castlight study illuminates the wide range of primary care costs across the United States. San Francisco and Sacramento are the most expensive cities for primary care, a primary care visit costs $251 and $219, respectively.
https://www.beckershospitalreview.com/hospital-physician-relationships/15-most-expensive-cities-for-primary-care.html
62. Payers push for outpatient surgery in North Carolina.
Recent projections predict that three out of four surgeries in the Triangle region of North Carolina will be performed in an ambulatory surgery center. Patients and physicians may be the key decision makers when it comes to surgery location, but payers are about to become key players in the arena, especially as demand for value and price rises.
63. Privately insured patients paid more for fewer medical services in 2013.
Privately insured Americans utilized fewer medical services in 2013 than the previous year, yet healthcare spending increased. The annual survey published by the Health Care Cost Institute revealed Americans younger than age 65 participating in employer health plans spent an average of $4,864 per enrollee in 2013, up $183 (3.9 percent) from the year before. Read the full report on Becker's Hospital Review.
64. EHR market to be worth $17B by 2017.
The electronic health record market, worth $10.6 billion in 2012, is expected to be valued at $17 billion by 2017, according to a GlobalData report.
65. Electronic transactions could save healthcare $8B.
Electronic transactions could save healthcare providers $6.7 billion and health plans $1.4 billion each year. Opportunities for electronic transfer savings lie in areas such as claims submission and benefit verification. Read the full report on Becker's Hospital Review.
66. Practice management system market to reach $247M by 2018.
The global practice management system market is expected to reach a value of $247.1 million by 2018, according to a Research and Markets report. The physician segment of the market is the largest and fastest growing market sector.
67. 54% of insured consumers confused by medical bills.
A recent survey by TransUnion Healthcare has found the majority (54 percent) of insured consumers are either sometimes or always confused by their medical bills. The survey found 63 percent of survey respondents want to know the full cost of care, including their insurance company's portion, while 35 percent said they only cared about their direct medical costs.
68. 10% of Americans have proficient level of health literacy.
Only about one in 10 people in the United States have a proficient level of health literacy, meaning they can understand and use health-related information in daily activities, according to Kaiser Health News report.
69. Sunshine Act database gets an overhaul.
After two weeks of difficulty navigating the Open Payments website, CMS issued a beta search tool for the database. CMS is currently soliciting feedback on the search tool and will make alterations to the website in a "refresh" that will occur on or before Dec. 31.
70. Colorectal cancer rate drops 30%.
A recent study published in the journal Cancer found that the rate of colorectal cancer among Americans 50 and older has fallen 30 percent in the last decade. The percentage of Americans up-to-date on recommended colorectal cancer screening increased from 55 to 65 percent during the past 10 years. Americans 65 and older have shown a 7 percent drop in colon cancer rates from 2008 to 2010.
71. Study reveals procedure times 25% quicker in ASCs than hospitals.
ASC procedures take an average of 31.8 fewer minutes than hospital procedures, with a 25 percent average time reduction between the surgery locations. Outcomes in hospitals and surgery centers were comparable, but surgical costs were between $400 and $1,000 lower for ASC cases.
72. Healthcare employee confidence foundering.
U.S. healthcare employees' confidence has fallen to the lowest level in over a year, decreasing from 59.8 in the second quarter of 2014 to 54.3 in the third quarter. However, the confidence index is still above 50.0, which indicates a positive confidence level on a scale from 0 to 100. Read the full report on Becker's Hospital Review.
73. Experts expect severe flu season.
The strain of the flu that has been most common in the U.S. this season, seasonal influenza A H3N2, is tied to more severe illnesses, hospitalizations and deaths than other flu strains, according to the Centers for Disease Control and Prevention. Read the full report on Becker's Hospital Review.
74. National Nurses United plan nationwide strikes over Ebola prep.
Members of National Nurses United in 12 states and Washington, D.C., planned to picket or strike Nov. 12 as the union sought stronger Ebola safety precautions in hospitals. Read the full report on Becker's Hospital Review.
75. Ebola could have $32.6B economic impact.
In addition to the human suffering the Ebola epidemic has caused, the outbreak is having a serious economic effect on West Africa and could have a $32.6 billion impact by the end of 2015 if it spreads to neighboring countries, according to a report from The World Bank Group. Read the full report on Becker’s Hospital Review.
76. UPMC research could change national endoscope cleaning guidelines.
National guidelines for endoscope cleaning may be updated due to research performed by UPMC's infection prevention team. Researchers found that standard cleaning protocols failed to kill all bacteria. UPMC began to use gas sterilization using for ethylene oxide for all scope disinfection.
77. DEA classifies hydrocodone as Schedule II drug.
A decade after the beginning of formal debate over regulation of hydrocodone, the U.S. Drug Enforcement Agency has issued a final rule on classification of hydrocodone combination products, moving the drug combination from a Schedule III to a Schedule II classification.
78. Prescription drug spending expected to increase 6.8% in 2014.
Prescription drug spending growth is projected to increase more drastically in 2014 than it has in the last few years, with a 6.8 percent increase in spending. The increase in prescription drug spending in 2014 is primarily due to the increased use of prescription drugs by those who have gained health coverage under the Patient Protection and Affordable Care Act. Read the full report on Becker's Hospital Review.
79. Drug recalls poised to hit record high.
If the number of drug recalls this year continues at its current rate, 2014 could bring in the highest number of recalls to date, according to a report from the Regulatory Affairs Professionals Society. As of Aug. 11, pharmaceutical companies have initiated a total of 836 drug recalls in 2014. In 2013, there were 1,225 recalls, a significant jump from the 499 recalls in 2012. Read the full report on Becker's Hospital Review.
Healthcare reform update
80. 6% of Americans enrolled in ACOs.
Research from Leavitt Partners estimates 6 percent of Americans are enrolled in an accountable care organization. ACO participation varies widely across the country. For example, 27 percent of Oregon's population is in an ACO, while Alabama has less than 2 percent of its population in an ACO.
81. 272+ ACOs in America.
CMS named the original 32 Pioneer accountable care organizations in December 2011. In July 2013, nine Pioneers left the program. But, the number of both government and commercial ACOs continues to grow. There are now more than 272 ACOs in the country.
82. ACOs overlook surgeons.
A new study has found Medicare's early ACOs have put little emphasis on surgical care. Instead, ACOs have focused on chronic conditions, readmissions and emergency department use.
83. ACOs drive patient satisfaction improvements, study says.
Accountable care organization patients reported greater satisfaction with some aspects of their care after one year in the program. Read the full report on Becker's Hospital Review.
84. PPACA initiative to invest $114M in ACOs.
CMS has announced a new initiative available to Medicare Shared Saving Program accountable care organization that will provide upfront investments in infrastructure and redesigned care process to help ACOs provide high-quality care. The initiative, called the ACO Investment Model, will provide up to $114 million in upfront investments to as many as 75 ACOs. Read the full report on Becker's Hospital Review.
85. Administration overhauls HealthCare.gov.
The Obama administration is in the process of making a number of changes to HealthCare.gov. The changes are being made to ensure that the problems that affected the exchange website during the fall will not reoccur during the next enrollment period. HealthCare.gov will also being using Amazon's cloud computing services.
86. HHS to spend $1.4B on HealthCare.gov.
Due to its botched rollout and continued glitches, HHS expects to spend $1.4 billion on HealthCare.gov this year.
87. HealthCare.gov cost more than double estimate.
Building and overhauling HealthCare.gov will cost the government much more than HHS has estimated through the end of fiscal year 2014. Read the full report on the Becker's Hospital Review.
88. Massachusetts insurance exchange to remain private.
Massachusetts will replace its problem-plagued health insurance exchange with another privately run system, rather than join the federally run marketplace. For the next enrollment period, beginning on Nov. 15, Massachusetts will use a system from hCentive, which has already been used in other states. Read the full report on Becker's Hospital Review.
https://www.beckershospitalreview.com/finance/massachusetts-will-not-shift-to-federally-run-marketplace.html
89. House passes 'keep your plan' bill.
In a 247-167 vote, the House has passed The Employee Health Care Protection Act of 2014, which would let people keep their insurance plans, even if they are not compliant with the Patient Protection and Affordable Care Act. Read the full report on gained .
90. 10.3M people gained insurance coverage under PPACA between January and June.
Approximately 10.3 million American adults gained health insurance coverage between January 2012 and June 2014, according to a study published in The New England Journal of Medicine. The researchers found a significant decline in the uninsured rate among nonelderly adults during the PPACA exchanges' first open enrollment period.
91. Uninsured rate drops 5 percent.
The uninsured rate for adults dropped from 20 percent in September 2013 to 15 percent in June 2014. This drop accounts for an estimated 9.5 million fewer uninsured adults.
https://www.beckershospitalreview.com/finance/survey-rate-of-uninsured-falls-to-15.html
92. Uninsured rate remains at record low in May.
The U.S. uninsured rate held steady at a record low of 13.4 percent in May, according to a recent Gallup poll. The uninsured population could also continue to shrink if more states opt to expand their Medicaid programs.
https://www.beckershospitalreview.com/finance/uninsured-rate-remains-at-record-low-22-statistics.html
93. Texas leads U.S. in insured rate post-PPACA.
Texas has the highest uninsured rate at 24.81 percent in the wake of the Patient Protection and Affordable Care Act. Mississippi follows closely behind with an uninsured rate of 21.46 percent. Massachusetts has the lowest rate at 1.2 percent.
https://www.beckershospitalreview.com/finance/10-states-with-highest-lowest-uninsured-rates-post-ppaca.html
94. Uninsured rate hits lowest level since 2008.
The U.S. uninsured rate decreased to 15.6 percent in the first quarter of this year. This is the lowest level since 2008.
https://www.beckershospitalreview.com/finance/u-s-uninsured-rate-hits-lowest-level-since-2008.html
95. Arkansas, Kentucky lead U.S. states in sharpest drop in uninsured rate.
A new Gallup poll has revealed the 10 states with the largest declines in uninsured rates since the Patient Protection and Affordable Care Act took effect at the beginning of the year all expanded Medicaid. Arkansas had a 10.1 percent decline in its uninsured rate this year and Kentucky had an 8.5 percent decline. Read the full report on Becker's Hospital Review.
96. 400k+ sign up for PPACA coverage.
The numbers are in: 462,125 people selected a healthcare plan from Healthcare.gov from November 15 to 21, and 48 percent of those individuals were first-time customers. Read the full report on Becker's Hospital Review.
97. Exchange plan members could face hefty premium increases next year.
Consumers enrolled in exchange plans who receive federal assistance to reduce their monthly premiums may face substantial premium increases unless they switch insurance plans in 2015.
98. PPACA support drops to 35%.
The percentage of Americans with a favorable view of the Patient Protection and Affordable Care Act fell from 37 percent in July to 35 percent this month in advance of the midterm elections, according to a Kaiser Family Foundation poll. However, the percentage of people expressing an unfavorable view of the law also dropped from 53 percent to 47 percent during the same time period. Read the full report on Becker's Hospital Review.
99. PPACA enrollment expected to take a sharp downturn.
As the eve of Nov. 15 is just days away, the start date of the second open enrollment period of the PPACA insurance exchanges, new data shows projected rates of enrollment have significantly dropped. Read the full report on Becker’s Hospital Review.
100. Most PPACA enrollees happy with plans.
The majority (68 percent) of people who purchased Patient Protection and Affordable Care Act marketplace coverage during the first open enrollment period are happy with their plans, according to a survey conducted by The Commonwealth Fund. Read the full report on Becker's Hospital Review.
101. Majority of PPACA insured to change healthcare plans in 2015.
Two-thirds of Americans insured under the Patient Protection and Affordable Care Act plan to switch healthcare plans in 2015. Read the full report on Becker's Hospital Review.
102. PPACA to increase number of medical malpractice claims.
A new study released by the RAND Corporation has found the Patient Protection and Affordable Care Act will increase the number of medical malpractice claims.
103. CBO: PPACA still to generate $124B in savings.
In response to an inquiry from Congress, the Congressional Budget Office has reiterated its March 2010 projection that the Patient Protection and Affordable Care Act will reduce federal budget deficits by a total of $124 billion from 2010 to 2019 and by approximately one-half of 1 percent of gross domestic product during the following decade.
104. PPACA driving care to outpatient settings.
Value-based payment models, risk-sharing arrangements and consumerism — all on the rise under the PPACA — favor providers delivering high-quality, low-cost services in the most convenient settings. Subsequently, from fiscal years 2010 to 2013, Fitch's rated hospital and health system portfolio showed a decline in inpatient activity, along with an increase in outpatient and ambulatory care. Read the full report on Becker's Hospital Review.
105. New HealthCare.gov CEO hopes to turn consumers into "raving fans."
HealthCare.gov CEO Kevin Counihan has said the federal health insurance exchange website will become so user friendly that it will prompt consumers to become "raving fans" of the Patient Protection and Affordable Care Act. Read the full report on Becker's Hospital Review.
ICD-10
106. President Obama signs into law ICD-10 delay, SGR patch.
President Barack Obama signed into law the Protecting Access to Medicare Act of 2014 (HR 4302). The law provides a one-year sustainable growth rate patch and delays ICD-10 implementation until Oct. 1, 2015.
107. CMS breaks silence, sets ICD-10 transition date for Oct. 1, 2015.
A CMS spokesperson issued a statement on ICD-10. "HHS expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning Oct. 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through Sept. 30, 2015."
108. CMS cancels July ICD-10 testing.
The Centers for Medicare and Medicaid Services cancelled the ICD-10 testing scheduled for July 21 to 25, 2014 due to the implementation delay. Additional opportunities for end-to-end testing will be available in 2015, according to the agency.
109. CMS accepts majority of claims submitted during March ICD-10 testing week.
In March, the Centers for Medicare and Medicaid Services conducted an ICD-10 testing week. Approximately 2,600 participating testers submitted more than 127,000 claims with ICD-10 codes to the Medicare Fee-for-Service claims system. Overall, CMS accepted 89 percent of claims. Some regions reported acceptance rates as high as 99 percent.
110. CMS suggests providers begin ICD-10 front-end testing in October.
The Centers for Medicare and Medicaid Services recommends providers, suppliers, billing companies and clearinghouses to begin ICD-10 front-end testing in October. Medicare is scheduled to update its systems Oct. 6. All stakeholders are able to submit acknowledgement test claims at anytime, but CMS advises waiting until after the systems updates.
https://www.beckersasc.com/asc-coding-billing-and-collections/cms-suggests-providers-begin-icd-10-front-end-testing-in-october.html
111. CMS extends partial ICD-10 code freeze.
The Centers for Medicare and Medicaid Services extended the partial ICD-10 code freeze until October 2016. The code freeze will allow no major revisions until October 2016 but will allow the addition of new diagnoses and technologies as needed. After the code freeze ends, normal revisions will begin again.
112. Another ICD-10 delay could cost $6.6B.
The American Health Information and Management Association estimates that another one-year delay in ICD-10 implementation would cost the healthcare industry an additional $1 billion to $6.6 billion.
113. ICD-10 expected to cost less than previously predicted.
The cost of the ICD-10 transition for small physician practices has been estimated at $22,560 to $105,506, but new data suggests these numbers are much higher than the true cost. A Journal of AHIMA study projects that the ICD-10 transition for small practices will actually cost anywhere from $1,960 to $5,900.
114. ICD-9 has no code for Ebola.
Under the ICD-9 coding system, Ebola is simply identified as 078.89: other specified diseases due to viruses. Under ICD-10, Ebola would have its own specific code: A98.4. A specific code could improve Ebola tracking in the company.
115. Study raises questions about ICD-10 and Patient Safety Indicators.
A study published in the Journal of the American Medical Informatics Association has raised concerns over the transition from ICD-9 to ICD-10 Patient Safety Indicators.
The study authors suggest that the ICD-10-CM translation poses risk for comparing safety incidents and inflating the number of Patient Safety Indicators.
116. CMS to offer 3 new ICD-10 testing weeks.
The Centers for Medicare and Medicaid Services announced three new weeks for ICD-10 testing. Providers, suppliers, billing companies and clearinghouses can test their ICD-10 coding during these three weeks:
• Nov. 12 to 21, 2014
• March 2 to 6, 2015
• June 1 to 5, 2015
117. Another ICD-10 delay possible.
A number of physician groups are pushing for another two-year delay for ICD-10 implementation. Despite advocacy efforts spearheaded by AHIMA and the Coalition for ICD-10 against delaying implementation, further delay may gain traction. An additional sustainable growth rate patch could come with an amendment derailing the Oct. 1, 2015 implementation. The current Congress is under pressure to pass a resolution on a Departments of Labor-Health and Human Services-Education bill that expires Dec. 11, according to the report. AHIMA's advocacy team believes there is a possibility an ICD-10 delay could be added as an amendment to the bill.
Leadership moves
118. ASCA elects new board of directors officers.
The Ambulatory Surgery Center Association elected Terry Bohlke, CASC, vice president of National Surgical Hospitals, president of the board. Other new offices include:
• Rebecca R. Craig, RN, CASC, CEO of Harmony Surgery Center and Peak Surgical Management in Fort Collins, Colo.: vice president
• Judy Harless, MBA, CASC, administrator of SMI Surgery Center in San Diego: secretary
• Clifford G. Adlerz, president and COO of Symbion: treasurer
119. AAAHC CEO to retire.
After 18 years with the association, John E. Burke, PhD, president and CEO of the Accreditation Association for Ambulatory Health Care, announced he will retire in June 2015.
120. AAAASF welcomes new CEO, COO.
The American Association for Accreditation of Ambulatory Surgery Facilities appointed James Pavletich, MHA, CAE, as CEO and Theresa Griffin-Rossi, CAE, as COO.
121. Ann Geier to serve as ASCA's AAAHC liaison.
The Ambulatory Surgery Center Association Foundation selected SourceMedical Solutions Vice President-Clinical Informatics Ann Geier as its liaison to the Accreditation Association for Ambulatory Health Care.
122. AGA Institute names Dr. John Allen president.
The American Gastroenterological Association announced John I. Allen, MD, MBA, AGAF, as its new AGA Institute president. Dr. Allen began his term at the conclusion of Digestive Disease Week.
123. Physicians Endoscopy names CDO.
Physicians Endoscopy named Rodger Baca as chief development officer. Mr. Baca previously served as a vice president of acquisitions and development at Ambulatory Surgical Centers of America.
124. Kathleen Sebelius to step down as HHS secretary.
Kathleen Sebelius resigned as HHS secretary. Her resignation came less than two weeks after the end of the first open enrollment period for the Patient Protection and Affordable Care Act exchanges. Sylvia Mathews Burwell has taken over the role.
125. Tom Tassone named AAAHC director of health plans.
The Accreditation Association for Ambulatory Health Care appointed Tom Tassone as director of health plans. In this role, Mr. Tassone is responsible for expanding Qualified Health Plans accreditation.
126. OASCA elects board of directors.
Bruce C. Johnson, MD, was elected to replace outgoing Oregon Ambulatory Surgery Center Association president Jesseye Arrambide, RN, BSN, CNOR, who will remain on the board. Shelley Yuva, administrator of Slocum Surgery Center in Eugene, was elected vice president
127. Surgical Notes names Chuck Meisel VP of sales.
Surgical Notes named Chuck Meisel vice president of sales. Mr. Meisel previously served as senior sales leader at Poplar Healthcare, Owens & Minor and ProVation Medical. In his new role, he'll use his 15 years of experience in the healthcare industry to further develop Surgical Notes' sales organization. He will be responsible for hiring, developing and mentoring a nationwide sales team.
Price transparency and bundled payment news
128. Price transparency initiatives could cut $100B in health spending.
Increased healthcare price transparency could potentially play a considerable role in payment reform and help contain costs, according to an analysis released by the nonprofit West Health Policy Center. If policy makers implemented a number of price transparency interventions they could reduce healthcare spending by $100 billion.
129. Price transparency could play a role in quality improvement.
A study published by UnitedHealthcare has found that tools designed to help patients estimate the cost of care may also play a role improving the quality of care provided. The payer based the study on its myHealthcare Cost Estimator. Early results of the study indicate that patients using the cost estimation tool tended to choose physicians that were considered high-quality and efficient.
130. Maine enacts 2 price transparency laws.
Two new state laws that aim to inject transparency and drive consumerism in healthcare will take effect in Maine. One law will require hospitals and ambulatory surgery centers to provide the average charge for any service or procedure on request. A second law will require healthcare providers to gather a list of their most common procedures, anything performed more than 50 times a year, and the price set for uninsured patients.
131. Rhode Island to make payer claims database public.
Rhode Island is scheduled to launch its all-payer claims database to the public this year. Six years ago the state's legislature mandated the creation of such a database, and now new funding is helping bring that database to the public. The Rhode Island Department of Health is contracting with Arcadia Healthcare Solutions, OnPoint Health Data and 3M Health Information Systems to aggregate and present the data, according to the report.
132. Massachusetts puts price tags on healthcare.
With the push for more transparency in healthcare, people with private insurance in Massachusetts can now go onto their insurers' websites to see the real-time prices for healthcare services. Read the full report on Becker’s Hospital Review.
133. Oklahoma and Idaho consider price transparency bills for ASCs.
Oklahoma is considering the passage of The Oklahoma Health Care Cost Reduction and Transparency Act of 2014 (HB 2400), which would require ASCs in the state to submit pricing to the state health department for the 100 most common diagnostic and surgical procedures. The Idaho House is considering HB 497, which would create a state pricing database of the 50 most common procedures performed at ASCs and hospitals.
134. Price transparency website launches in Maryland.
The Maryland Health Care Commission established the Maryland Health Care Quality Reports website, which offers consumer data on hospitals, ambulatory surgery centers and long-term care. The new tool allows consumers to evaluate the cost of the 25 most common medical procedures, as well as providers' quality and safety results.
135. Jeff Blankinship launches price transparency platform.
Jeff Blankinship, president of Surgical Notes and Surgery Center Network, founded I Need a Surgery. INS is a direct-to-consumer surgical solution and educational platform designed to bring price transparency to the field of surgery.
136. 4 ASCs add pricing data to PricingHealthcare.com.
The Orthopedic Surgery Center of Orange County in Los Angeles; Monticello Surgery Center in Charlottesville, Va.; the Surgery Centers of ENT Institute in Atlanta; and St. George (Utah) Surgical Center have listed pricing data on the website PricingHealthcare.com in June.
137. MEDARVA Stony Point Surgery Centers posts prices online.
MEDARVA Stony Point Surgery Center in Richmond, Va., posted the out-of-pocket costs for its top 25 to 30 surgical procedures on its website. Online pricing is available in multiple specialties.
138. Pennsylvania physician launches price transparency company.
William Hennessey, MD, a Pennsylvania physical medicine and rehabilitation physician, launched the company Pratter, which will share hospital, ambulatory surgery center and other healthcare provider fees on its website. Eventually, Dr. Hennessey intends to generate reports based on website queries as a source of revenue
139. Vitals acquires price transparency company.
Vitals, a physician rating platform, acquired the price transparency company Compass Healthcare Advisers. Compass Healthcare Advisers' price transparency platform uses data from health plans and employers. With the acquisition, Vitals' rating system will be combined with the price transparency platform.
140. Surgery Center of Oklahoma saves $600k for local government.
Oklahoma City-based Surgery Center of Oklahoma saved the Oklahoma County government approximately $573,000 in medical bills in the five months of its agreement with the county to provide surgery for public employees. As of July 17, the ASC has performed 89 surgeries on public employees at a cost of nearly $336,000, just over one-third of the potential total cost of the surgeries through other providers.
141. Hospitals, payers concerned over New York price transparency study.
A new study, funded by the New York States Department of Financial Services, aimed at bringing price transparency to the state's market is sparking concern amongst hospitals and payers alike. Hospital and payer leaders expressed concern that the study is too narrow in focus, fails to take into account the complicated nature of contracts and reveals pricing information without context.
142. 4,000+ healthcare providers to take on bundled payments.
CMS has announced 4,122 providers will be added to phase 1 — the exploratory, non-risk bearing stage — of the Medicare Bundled Payments for Care Improvement initiative, joining the 2,412 providers already participating. Read the full report on Becker's Hospital Review.
143. California bundled payments program fails to meet cost-savings goal.
Three years after a pilot bundled payment program was implemented in California, a RAND Corporation study shows the program failed to meet its cost-saving goals. The Integrated Healthcare Association launched the program in 2010 to adopt bundled payments for orthopedic procedures among commercially-insured individuals younger than 65. Read the full report on Becker's Spine Review.
144. Bundled payments save $33M in cancer care.
In October 2009, researchers launched a study of bundled payments in five medical oncology groups. Through the alternative to fee-for-service payment model, the total cost of care for patients with three different types of cancer was reduced by $33 million.
145. Bedford ASC, Harvard-Pilgrim Healthcare launch bundled payments pilot program.
The bundled payments program between Bedford Ambulatory Surgical Center and health plan Harvard-Pilgrim Healthcare include routine colonoscopy. The bundled rate includes fees for the surgeon, anesthesiologist and all other clinicians. The program, available to Harvard-Pilgrim Healthcare customers, includes more than one bundled fee. The fees are based on patient risk factors.
146. Big data company partners with HCI3 for bundled payments initiative.
HealthQx, a big data analysis company, partnered with the Healthcare Incentives Improvement Institute to enable bundled payment solutions. "Our unique combination of national big data combined with leading-edge analytics in ClarityQx, makes bundled payments truly viable and scalable for payers and providers," said HealthQx COO Bill Conlan.
147. HCI3 releases tools to support bundled payments.
The Health Care Incentives Improvement Institute released more than 80 evidence-informed case rate definitions. An ECR includes all covered services for a particular illness or procedure. The tools are designed to be used as an aid in creating a bundled payment model, use in accountable care payment programs, reference-pricing initiatives and analysis of provider cost and quality.
148. Two Tennessee endoscopy centers, MDSave partner for bundled payments.
Associated Endoscopy in Hermitage, Tenn., and St. Thomas Medical Group Endoscopy Center in Nashville, Tenn., partnered with MDSave to create a colonoscopy bundled pricing program. The pilot program's bundled price will include all costs associated with the procedure, including any biopsies. The new pilot program will offer a bundled rate of $1,795.
Reimbursement news
149. ASC payments to increase 1.4% in 2015.
Ambulatory surgery center payment rates will rise 1.4 percent in 2015. The bump in payment is based on a 1.9 percent expected rate of inflation minus a 0.5 percent productivity adjustment, as required by the Patient Protection and Affordable Care Act. The payment increase is 0.2 percent higher than the 1.2 percent update included in the Medicare proposed rule.
150. ASCA successfully negotiates with CMS over proposed payments.
The Ambulatory Surgery Center Association reported that the CMS 2015 proposed payment schedule for ASCs includes several points it successfully negotiated. ASCA successfully negotiated for issues such as the addition of 10 new spine procedures added to the list of 2015 payable procedures.
151. CMS payment changes do not eliminate colonoscopy cost-sharing.
The proposed rule would redefine colorectal cancer screening colonoscopy to include anesthesia. As a result, Medicare Part B deductible and coinsurance will be waived for anesthesia services charged separately. The GI societies appreciate this move towards eliminating barriers to colorectal cancer screening, but they express disappointment that CMS has not made the same move to eliminate coinsurance for colonoscopy including polyp removal.
152. California Division of Workers' Comp proposes ASC fee schedule changes.
The California Division of Worker's Compensation suggested changes to the ambulatory surgery center and hospital outpatient department fee schedule, which would eliminate alternative payment methodology. The California Ambulatory Surgery Association opposes the changes and filed formal comments with the DWC.
153. Study recommends no change in workers' comp fees for California ASCs.
A recent study examining outpatient surgical fees for California's worker's compensation recommends no change in the fees. The study, required by the state's 2012 workers' compensation reform law, did not provide support for allowing any procedures from the "inpatient only" list to be performed in the outpatient setting, except perhaps certain types of spinal fusion.
154. CMS adds 4 new modifiers.
One of the most incorrectly reported modifiers is the -59 modifier (distinct procedural service). Only under certain circumstances should the -59 modifier be applied. The overuse and misuse of the -59 modifier has been a red flag to Medicare and the OIG to the point that Medicare has now established four new modifiers that will go into effect Jan. 1, 2015. Read the full report on Becker's ASC Review.
155. CMS to reimburse $502 for Cologuard.
The Centers for Medicare and Medicaid Services issued its final payment decision for Exact Sciences' FDA-approved noninvasive stool DNA colorectal cancer screening test Cologuard. CMS will reimburse providers $502 per test. The payment decision follows a joint FDA and CMS review pilot program. Cologuard became the first technology to gain approval through this process.
156. Payers list of in-network physicians often outdated.
The array of in-network physicians insurers offer patients may be narrower than they seem, because the lists often include erroneous or out-of-date names or addresses. Read the full report on Becker's Hospital Review.
157. Physician and payer value-based payment perspective widely differs.
A new study released by FTI Consulting has found a disparity between payers and physicians when it comes to value-based payment models. Only 16 percent of physicians were willing to accept the required financial risk, but 80 percent of payers say value-based contracts are "very important" for overall strategy.
158. Health Net allows joint replacements in select California ASCs.
Health Net Medical Director Michael Fine, MD, recommended the Health Net Medical Advisory Committee allow some minimally invasive knee and hip replacements performed in ambulatory surgery centers for commercial members after meeting with the California Ambulatory Surgery Association Board and ASC leaders.
159. Study finds Medicare reimbursement does not favor surgeons.
It is a widely held perception that Medicare reimbursement favors surgeons and physicians that perform procedures over physicians who do not. But, a recent study published in the Annals of Surgery may dispel that common assumption. Read the full report on Becker's ASC Review.
Physician corner
160. U.S. ranks 25th in international physician count.
The United States has only 2.5 practicing physicians per 1,000 people, putting it 25th in terms of physician count per capita among international peers. Greece leads the world with 6.2 practicing physicians per 1,000 people. Read the full report on Becker's Hospital Review.
161. Physicians generate $1.6 trillion in economic benefits.
In 2012, the more than 720,000 physicians in the United States generated $1.6 trillion in direct and indirect economic benefits, according to the American Medical Association.
162. 21% of physicians across all specialties employed by hospitals.
Overall, 21 percent of physicians in all specialties are employed by a hospital. The number of primary care physicians employed by a hospital rose from 10 percent in 2013 to 20 percent in 2014.
163. 24% of physicians considering selling their practice.
Nearly one-fourth, 24 percent, of physicians report considering the sale of their practice, according to The Second Annual Practice Profitability Index: 2014 Edition. Twelve percent of physicians are actively seeking to sell their practice and 11 percent already have, according to the report.
164. 76% of physicians who experienced decreased income plan to leave private practice.
Three quarters of physicians, 76 percent, who had an income decrease in the last year said they would not remain in private practice because overhead costs were too high, according to a Jackson Healthcare report. On the other hand, of those physicians who experienced an increase in pay 91 percent say they will be practicing medicine this year.
https://www.beckersasc.com/news-analysis/will-physicians-stay-in-private-practice-20-statistics-based-on-income.html
165. Hospital acquisition of physician practices down.
In 2011, hospitals and health systems accounted for more than half of all physician practice acquisition deals. In 2013, they accounted for just 14 percent. Physician practice management companies are stepping up to account for a large amount of practice acquisitions.
166. U.S. to be short 90k physicians by 2020.
According to projections by the Association of American Medical Colleges, the nation will be short more than 90,000 total physicians by 2020 and 130,000 physicians by 2025.
167. AMA policy addresses physician shortage.
The American Medical Association voted to support innovative education models to address physician shortages in undersupplied specialties and underserved areas. The new policy encourages the federal and state government, as well as private payers, to satisfactorily fund graduate medical education and increase the number of available GME slots.
168. 59% of patients focus on physician interaction, rather than health outcomes.
When rating physicians, the majority of Americans (59 percent) focus more on their interactions with the physician, while just 29 percent focus on health outcomes. Top qualities patients look for include listening skills and attentiveness.
169. CMS open payments website launches.
CMS's Open Payments website has finally launched for the public, in accordance with the Physician Payments Sunshine Act, despite months of questions, criticisms, objections and several occasions of being taken offline. Read the full report on Becker's Hospital Review.
170. Majority of physicians report patient satisfaction has no bearing on income.
For most physicians, compensation is not tied to patient satisfaction. When asked how much of their compensation is tied to patient satisfaction, 73 percent of physicians responded with "none."
171. Physician compensation increases on the decline.
Increases in median total cash compensation for physicians were lower in 2014 than 2013, according to the 2014 Physician Compensation and Productivity Survey from Sullivan, Cotter and Associates. Read the full report on Becker's Hospital Review.
172. Gastroenterologist compensation increases 9%.
Gastroenterologist compensation increased 9 percent during 2013, according to an American Medical Group Association recently released 2014 Medical Group Compensation and Financial Survey. Across all specialties, physician compensation increased 2.9 percent in 2013.
Legislative updates
173. Legislation could grant ASCs voice on CMS advisory panel.
The House Committee on Ways and Means has put forth the "Hospital Improvements for Payment Act of 2014," which would allow an ASC representative a position on the Advisory Panel on Hospital Outpatient Payment. The 19-member panel meets three times a year to advise CMS on coding, accounting and outpatient business office functions.
174. 9 legislators sign on to ASC Quality & Access Act.
More than 80 Ambulatory Surgery Center Association members attended the ASCA 2014 Capitol Fly-In event to advocate for the ASC industry. After the event, nine new co-sponsors were added to the ASC Quality & Access Act.
175. Florida Senate kills bill proposing 72-hour stays at ASCs.
The Florida House supported a bill that would allow state ASCs to keep patients for up to three days after a procedure, but the state Senate killed the bill. The Florida Hospital Association strongly opposed the bill.
176. New Hampshire bill would allow 48-hour stays at ASCs.
The New Hampshire Ambulatory Surgery Association expressed support for SB 250, which would allow ASCs the ability to keep patients for 48 hours. The current state law requires patients to discharge or transfer patients at 24 hours.
177. Oklahoma rejects bill that would add ASCs to state health plans.
A bill offering Oklahoma state employees coverage for surgeries at ambulatory surgery centers died in the state's Senate Appropriations Committee.
178. South Carolina CON law remains in place.
Despite Governor Nikki Haley's veto of the certificate of need program's funds and the Department of Health and Environmental Control request to revisit its ruling, the Supreme Court stood firm by its ruling that requires the state to continue operating its CON program. The DHEC expects to begin accepting applications again in mid-July.
179. North Carolina CON law may be subject to reform.
North Carolina legislators plan to initiate CON law reform in 2015. The reform is aimed at increasing market competition to help reduce the cost of care.
180. Oregon representative reaffirms ASC industry support.
Oregon House Majority Leader Val Hoyle (D-14) reaffirmed her support of the ambulatory surgery center industry. Representative Hoyle spoke at the 2014 Annual Education Conference and Trade Show sponsored by the Oregon Ambulatory Surgery Center Association.
181. Illinois legislation leads to changes for Medicare-certified ASCs.
Illinois Governor Pat Quinn signed SB 3465 into law, amending the definition of an ASC in Illinois to include "any facility that meets the federal Medicare definition of an ambulatory surgery center," according to an Ambulatory Surgery Center Association of Illinois report. The legislation also allows the Illinois Department of Public Health to incorporate Medicare standards into ASC reviews automatically, even when the IDPH works through the rulemaking process.
Quality and safety
182. Voyance recognizes 53 ASCs, 10 endoscopy centers for quality.
Voyance announced the 2013/2014 National APEX Quality award winners, including 53 ASCs and 10 endoscopy centers. Read the full list of winners.
183. CMS inquiry reveals numerous errors occurred during Joan Rivers' procedure.
Results of the federal investigation into Joan Rivers' death following an elective procedure at New York-based Yorkville Endoscopy have been released, and they show the center made several preventable errors to which her death could be attributed.
184. Joan Rivers' death sparks public scrutiny of outpatient surgery.
Following comedienne Joan Rivers' death after an endoscopy procedure, outpatient surgery in the United States has undergone an unusual amount of scrutiny, with most major news outlets now focused to some degree on outpatient surgery and ASCs.
185. ASC Quality Reporting Program now includes cataract and endoscopy measurement tools.
The Ambulatory Surgical Center Quality Reporting Program now offers a Cataract Data Collection Tool and Endoscopy Tool Flow Charts. These tools are designed to assist with ASC-9, ASC-10 and ASC-11 quality measure data collection.
186. CMS delays ASC-11 implementation.
CMS delayed the new quality reporting measure ASC-11, "Cataracts: Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery" until Jan. 1, 2015. This delay does not impact ASC-9 or ASC-10 for endoscopy/polyp surveillance.
187. CMS launches certification number look-up tool.
CMS is making available a tool to assist ambulatory surgery centers in locating their CMS certification number to complete the CDC's National Healthcare Safety Network registration process. CMS is requiring ASCs to submit data for the ASC-8: Influenza Vaccination Coverage among Healthcare Personnel measure under the ASC Quality Reporting Program.
188. CMS ruling: ASCs no longer require radiologists.
The Centers for Medicare and Medicaid Services no longer requires ambulatory surgery centers to have a radiologist on their medical staff. CMS removed the Conditions for Coverage provision in a new rule that was released in the pre-published final form titled "Medicare and Medicaid Programs: Regulatory Provisions to Promote Program Efficiency, Transparency and Burden Reduction."
189. CMS now requires accrediting agencies to report ASC infection control breaches.
CMS mandated that any infection control breaches identified during Medicare Deemed Status Surveys must be reported by the state survey agency or accreditation organization to the appropriate state authorities.
190. CMS: Physician Compare adds quality data.
For the first time, CMS-run website Physician Compare has added group-level quality data for physician group practices and accountable care organizations in its database. The database includes quality data reported by 66 group practices and 141 ACOs thus far.
191. CMS proposes new emergency preparedness requirements.
The Centers for Medicare and Medicaid Services proposed expanded emergency preparedness requirements for providers, including ambulatory surgery centers.
192. CMS renews Joint Commission's deeming status.
CMS renewed The Joint Commission's ambulatory surgery center deeming authority from Dec. 20, 2014 through Dec. 20, 2020. The Joint Commission's standards for ASC surveying meet or exceed those required by CMS, leading to the recertification.
193. Joint Commission announces 2015 patient safety goals.
The Joint Commission released its 2015 national patient safety goals for ambulatory organizations, effective Jan. 1, 2015. The goals include identifying patients correctly, using medications safely, preventing infection and preventing mistakes in safety.
194. Joint Commission revised pain management standard to go into effect.
The Joint Commission's Revision to the Provision of Care, Treatment and Services standard PC.01.02.07 will go into effect Jan. 1, 2015. The standard, which addresses pain management, applies to ambulatory care, critical access hospitals, home care, hospitals, nursing care centers and office-based surgery accreditation programs.
195. Joint Commission releases ambulatory equipment maintenance checklist.
The Joint Commission released a checklist for determining the effectiveness of equipment maintenance. The 11-question checklist covers several topics including inventory practices, maintenance schedules, documentation and personnel.
196. ASCs required to collect data on ASC-8.
Flu season officially started on Oct. 1, 2014. ASCs are required to collect data on ASC-8: Influenza Vaccination Coverage among Healthcare Personnel from Oct. 1 through March 31, 2015, as part of Medicare's ASC Quality Reporting Program. ASCs must register with the National Healthcare Safety Network, which is managed by the Centers for Disease Control and Prevention.
197. ASCA launches quality and safety resource.
The Ambulatory Surgery Center Association created a website resource page on quality, safety and accreditation concerns. The website covers federal and state requirements for Medicare participation in comparison to HOPD standards. The page also provides a brief history of quality measurement in ASCs as it concerns the ASC Quality Collaboration and CMS' national quality reporting program.
198. CMS removes antibiotic prophylaxis measure from PQRS.
CMS has removed the antibiotic prophylaxis measure from the final Physician Quality Reporting System list for 2015 and to avoid the PQRS penalty next year, all eligible professionals must report at least one "cross-cutting" measure.
199. CMS to start data collection on two new quality measures for 2015.
Data collection for ASC-11 (cataracts: improvements in patent's visual function within 90 days following cataract surgery) begins Jan. 1, 2015 and goes until Dec. 31, 2015. Data collection for ASC-8 (influenza vaccination coverage among healthcare personnel) began Oct. 1, 2014 and goes through March 31, 2015.
200. AORN to update local anesthesia care guidelines.
The Association of periOperative Registered Nurses plans to release an update to its 2007 Recommended Practices for Managing the Patient Receiving Local Anesthesia next year.
https://www.beckersasc.com/anesthesia/aorn-to-update-guidelines-for-local-anesthesia-care.html
201. AORN launches Ebola preparation tool.
The Association for periOperative Registered Nurses released guidelines for perioperative personnel for taking care of Ebola patients in surgical settings in its AORN Journal. The guidance includes recommendations for personal protective equipment for nonscrubbed team members, scrubbed team members, environmental services team members and sterile processing team members.
202. ACS release protocol for Ebola in the OR.
The American College of Surgeons released protocols for surgical cases involving patients with possible or confirmed cases of Ebola. While the protocol notes operations should not be performed on patients with known or suspected cases of Ebola, emergency procedures may leave surgical teams with no choice.