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Pa. Report: ASCs Save Medicare $464 Million Annually
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An independent report on Pennsylvania's ASCs has turned up some interesting statistics. The report, entitled Financial Analysis 2006, Volume Two, reported a total of 205 licensed ASC facilities in the state with 28 facilities having opened between June 2006 and May 2007. The report also indicated a 17-point increase in the number of outpatient diagnostic and surgical (D&S) procedures over a six-year period. In 2006, ASCs performed 622,652 of the total 2.3 million outpatient D&S procedures in the state.
"The continued growth of ambulatory surgery centers demonstrates that there is a need ... for alternative, low-cost, high-quality outpatient surgical services within our communities," says Rick Bloxdorf, the president of the Pennsylvania Ambulatory Surgery Association and administrator for Village SurgiCenter of Erie, Pa. The following statistics bear this out, he says:
- Payers save money. Medicare payment to ASCs for high-volume procedures is lower than Medicare payment to outpatient department of hospitals for the same procedures. In 2008 the difference will be 37 percent. Studies have shown the Medicare program would pay approximately $464 million per year more if all procedures performed in an ASC were instead furnished at a hospital.
- Consumers save money. A Medicare beneficiary could pay as much as $496 in co-insurance for a cataract extraction procedure performed in a hospital outpatient department, whereas the maximum out-of-pocket cost for the same beneficiary to receive the service in an ASC is $195. Likewise, a Medicare beneficiary could pay as much as $186 in coinsurance for a colonoscopy performed in an outpatient department of hospital but only $89 if they had the procedure in an ASC.
- Employers often achieve similar savings when their employees choose ASCs as the Medicare program does for its beneficiaries. Reimbursement from private insurers for the same outpatient surgical procedures performed in an ASC setting is lower than in an outpatient hospital setting. As in Medicare, both the insurance company and the patient pass less for their care if they use an ASC.
The report is the product of the Pennsylvania Health Care Cost Containment Council, an independent state agency charged with collecting, analyzing, and reporting information that can be used to improve the quality and restrain the cost of healthcare in Pennsylvania. In addition to ASCs, the report also includes data representing the financial health of other non-general acute care facilities, including long-term acute care, rehabilitation, psychiatric, and specialty hospitals. Copies of the report are available online.
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| News and Notes
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Medicare Part B will soon make up half of federal health spending. The federal government's Medicare and Medicaid programs are fast approaching a critical mass, David M. Walker, the comptroller general of the United States, said in a speech before the National Conference on Health Care Consumerism in Washington, D.C., earlier this month. In 2007, for example, Medicare Part A outlays will have exceeded cash income, making it a trigger year for a "Medicare funding warning," and 2013 is the "projected date that annual 'general revenue funding' for Part B" - under which surgery is covered - "will exceed 45 percent of total Medicare outlays." Further, the percentage of companies offering third party insurance is on the decline, and monthly premiums have more than quadrupled over the past seven years. Mr. Walker discussed about a dozen potential action strategies, noting that the sooner the government begins looking at reform, the better, as "Our demographic changes will serve to make reform more difficult over time."
Jan./Feb. ASC Review's. We expect a record Jan./Feb. issue. It focuses on 40 companies to watch, an orthopedics and spine medical device market letter and bariatrics in ASCs. The advertising deadline for the issue, which will be distributed to 25,000 people, including approximately 19,000 surgeons and proceduralists, is Dec. 14. Should you have questions about advertising in future issues of the Becker's ASC Review please e-mail Jessica Cole or call her at (312) 505-9387; e-mail Emily Noyes or call her at (773) 454-7445; or e-mail Ryan Kiernan or call him at (202) 337-1893.
New SPSmedical Web site launched. SPSmedical has launched its redesigned Web site featuring sterilization products, services and educational programs. The site segments sterilization products and services as well as articles and other educational resources according to sterilization process (steam, EtO gas, gas plasma, peracetic acid, dry heat and chemical vapor). Users can also track upcoming audio seminar dates and topics, new product releases and industry changes. For more information, call (800) 722-1529 or visit the Web site.
John Cherf. Thank you to John Cherf, MD, MBA, MPH, who spoke at our last Webinar. More than 50 people heard John's comments on orthopedics for the next several years. He did a terrific job and had outstanding information. Dr. Cherf may be the perfect board member for a healthcare company or speaker at an event; you can contact him here.
ASC Communications is Hiring. We are seeking a very smart, very high-energy college graduate or ad sales person to work with ASC Communications in Chicago. If you know of someone who may have an interest, please let me know or have them e-mail Scott Becker or Emily Noyes. The position is challenging and will entail a variety of sales and administrative roles. The focus is expected to be on circulation management, electronic sales, and audio conference development and management.
Update on June Orthopedic- Pain Management- and Spine-Driven ASC Conference: Tucker Carlson to speak. The agenda and program for this event is nearly complete. We will have a robust agenda with approximately 70 different presentations. Further, given the proximity to the '08 presidential race, we have secured political commentator Tucker Carlson as a lead or keynote speaker. Overall, it will be a terrific event.
We will again be offering CME credit for physicians and we expect to exceed last year's attendance of 480 at this event. Aside from sizable attendance, we receive great feedback on the quality of the audience.
Should you have questions regarding sponsoring or advertising, please e-mail Scott Becker, and he will refer you to the right person; or e-mail Jessica Cole, e-mail Emily Noyes or e-mail Ryan Kiernan. For editorial ideas or news and notes, please e-mail Stephanie Wasek.
Welcome new advertisers. Thank you to Galil Medical, which is helping ASCs add prostate cryotherapy, a urologist-driven procedure, to ASCs. For more information, e-mail Marie Molnar Hammond. We also thank Bob Wood and Acclarent. Bob and his company have developed a device for a sinus procedure that can be hugely helpful to patients and a great addition for ASCs. For more information, e-mail Bob.
We are delighted to welcome Tom Yerden and TRY Health Care Solutions, which provides consulting services to large healthcare systems, group practices, independent physicians and surgery centers throughout the United States. We also welcome Larry Taylor and Practice Partners, a privately held corporation dedicated to providing management and operational services to ASCs.
Thank you, new advertisers. We also welcome Amkai, maker of AmkaiCharts, a comprehensive electronic medical record system specifically for ASCs and surgical hospitals encompassing nearly all specialties. Please e-mail Craig Veach for more information.Thank you as well to Blue Chip Surgical, which has been remarkably successful with several highly profitable, physician-led centers in operation around the country and a number of projects in the works. For more information, please e-mail Jeff Leland, a real veteran of the ASC industry.
And we'd also like to thank Surgical Notes, led by Dennis Blankenship and Jeff Blankenship, a leading nationwide provider of medical transcription, coding, and other related value-added information technology services for the ASC market. Thank you to Manning Search Group, which offers middle management and executive search and recruitment with ASC-industry-specific focus, for joining the ASC Review. E-mail Roger Manning or Cathy Montgomery for more information.
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| Companies to Watch |
We are delighted to highlight the following companies in this week's E-Weekly.
CIT Healthcare. CIT Healthcare offers a full spectrum of financing solutions and related advisory services to companies across the healthcare industry. Through
its client-focused and industry-centric model, CIT Healthcare effectively leverages CIT's extensive knowledge and understanding of the healthcare marketplace and approximately $80 billion "A" rated balance sheet. Financing solutions include real estate debt and equity financing; M&A advisory services; cash flow loans; asset-based loans;
large/small leases/loans; and working capital lines of credit. For more
information, please visit www.cithealthcare.com or contact CIT Healthcare at
(800) 547-7026.
TRY Health Care Solutions. TRY Health provides consulting services to large healthcare systems, group practices, independent physicians and surgery centers throughout the United States. Tom Yerden, president of TRY Health, is a recognized leader in the industry with over 25 years of service spanning the development of more than 70 surgery centers and the founding of Aspen Healthcare in 1992. Tom is a member of the FASA board of directors and was a finalist for the 2003 Ernst & Young, Entrepreneur of the Year. Tom speaks at many national conferences each year and spends his free time assisting his wife Carol in raising their herd of 70 Alpacas in Salmon, Idaho. You can contact Tom at (208) 865-2400.
Eveia Health Consulting & Management Company Founded by I. Naya Kehayes, MPH, Eveia Health Consulting & Management is comprised of a team of seasoned professionals who are experts in reimbursement management, managed care contracting, and business management with a specialization in ASCs and surgical practices. Senior Management serve as advisors to national corporations and provide leadership in health policy initiatives related to reimbursement on behalf of ASCs at both state and federal levels.
Eveia's services include contracting and contract analysis, acting as administrator and manager, customizing revenue management, financial analysis, and enhancing and maximizing the financial position of clients. In addition, Eveia implements training and reimbursement calculators, and it provides feasibility studies, payor due diligence, fee schedule development and coordination of business related activities. Eveia has serviced more than 100 clients in 25 states since its inception in 1998. For more information, call her at (425) 657-0494, or visit www.eveia.com.
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If you have any questions on any of the items listed in this letter, please contact me at (312) 750-6016 or by email at sbecker@mcguirewoods.com.
Very truly yours,
 Scott Becker
SB/kjd
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