It can be difficult to stay abreast of the changes in the healthcare industry today, but it's very important for surgery center leaders and physicians to understand the consequences of new legislation and advocate for bills that will keep the ASC industry competitive. The Ambulatory Surgery Center Association (ASCA) has organized a group of people dedicated to lobbying on Capitol Hill on behalf of the ASC industry and encourages all surgery center leaders and physicians to become involved in these efforts.
"In this day and age with the complexity of things happening in healthcare and federal agencies, we all have a responsibility to remain vigilant," says ASCA Chief Executive Officer William Prentice. "You can't rely on just asking a government affairs staff member to protect the industry. We need every person in the ASC community to help us advocate on behalf of our healthcare delivery model."
Mr. Prentice discusses ASCA's lobbying efforts and how individual industry members can become involved at the local and national levels.
Q: What are the big issues the ASCA lobby is focusing on right now?
William Prentice: We have continued lobbying support for our ASC legislation, which has been introduced in both the House and the Senate. We have more than 40 co-sponsors to the bill at this point. Recently, more than 30 members of the ASC community traveled to Capitol Hill to meet with lawmakers and lobby for its passage. The most important element of the bill is to change the way Centers for Medicare and Medicaid calculates our reimbursement each year. The measurement tool undervalues the costs of goods and services in our market every year and we want to make sure the rate is reasonable for outpatient surgery centers.
ASCs receive a percentage of the reimbursement that hospitals and hospital outpatient departments do for performing the same procedures. Over the past decade, the delta between hospital and ASC reimbursement has gone from ASCs being reimbursed at 86 percent of hospital outpatient departments to 58 percent this year.
Q: Beyond reimbursement, are there any other big issues you are working on in Washington?
WP: We are also spending a lot of time on drug shortages — predominantly anesthetics. Facilities are experiencing real shortfalls in the ability to obtain the drugs they need and that impacts scheduling and patient care. We are working with other affected groups in Washington to draw attention to these issues. It's a really big problem and we need to address it in the near future.
Q: What is the lobbying environment like on Capitol Hill right now?
WP: All eyes are on the Supreme Court, waiting to find out how they are going to rule on the individual mandate contained in the healthcare reform law. The Supreme Court could do a number of things: they could rule the individual mandate is unconstitutional and leave the rest of the bill standing; they could rule the whole thing is unconstitutional and that would result in a lot of changes; or they could rule it constitutional. That's going to be really important and something we are keeping our eye on.
Q: How can ASC administrators, physicians and advocates become involved in lobbying efforts at the national and local levels?
WP: We have a very active grassroots network and we encourage all ASCs to participate. We have weekly updates on the happenings in Washington, D.C., and we would like to see everyone become more involved. People should find out who their members of Congress are so they can meet with them and educate them on the valuable role ASCs play in the healthcare system and in their community. We have staff members here at ASCA who are willing to connect ASCA members with their lawmakers.
Our website has information about how ASC professionals can approach conversations with government officials and develop their relationships with their elected officials. We also have issue briefs on our website on the major issues that impact the ASC industry on Capitol Hill.
Q: Are there any activities going on that would be of interest to particular constituents in the ASC industry?
WP: We recently endorsed a bill that attempts to fix a flaw in the healthcare reform law. There is a provision in the law that entitles Medicare beneficiaries to one free colonoscopy screening without any copay; that's a great provision and we need to encourage more seniors to have colonoscopies. However, the flaw is if they go in for the free colonoscopy and the physician finds something wrong — a polyp or cancer — the screening turns into a diagnostic colonoscopy and the patients are now responsible for the co-pay.
We have endorsed legislation to fix that flaw so patients won't have to receive bad health news and, then, have to make an unexpected out-of-pocket payment. There are several GI groups endorsing and supporting it. The only way we can remedy this flaw is by passing a new law and we hope Congress will act so there isn't a barrier to people receiving their colonoscopy screenings.
More Articles on Surgery Centers:
7 Reasons for Claim Denials in Surgery Centers—and How to Fix the Problem
4 Tactics Payors Use to Drive Surgery Centers In-Network—and How to Respond
When 5010 Implementation Delays Surgery Center Payment: 4 Ways to Respond
"In this day and age with the complexity of things happening in healthcare and federal agencies, we all have a responsibility to remain vigilant," says ASCA Chief Executive Officer William Prentice. "You can't rely on just asking a government affairs staff member to protect the industry. We need every person in the ASC community to help us advocate on behalf of our healthcare delivery model."
Mr. Prentice discusses ASCA's lobbying efforts and how individual industry members can become involved at the local and national levels.
Q: What are the big issues the ASCA lobby is focusing on right now?
William Prentice: We have continued lobbying support for our ASC legislation, which has been introduced in both the House and the Senate. We have more than 40 co-sponsors to the bill at this point. Recently, more than 30 members of the ASC community traveled to Capitol Hill to meet with lawmakers and lobby for its passage. The most important element of the bill is to change the way Centers for Medicare and Medicaid calculates our reimbursement each year. The measurement tool undervalues the costs of goods and services in our market every year and we want to make sure the rate is reasonable for outpatient surgery centers.
ASCs receive a percentage of the reimbursement that hospitals and hospital outpatient departments do for performing the same procedures. Over the past decade, the delta between hospital and ASC reimbursement has gone from ASCs being reimbursed at 86 percent of hospital outpatient departments to 58 percent this year.
Q: Beyond reimbursement, are there any other big issues you are working on in Washington?
WP: We are also spending a lot of time on drug shortages — predominantly anesthetics. Facilities are experiencing real shortfalls in the ability to obtain the drugs they need and that impacts scheduling and patient care. We are working with other affected groups in Washington to draw attention to these issues. It's a really big problem and we need to address it in the near future.
Q: What is the lobbying environment like on Capitol Hill right now?
WP: All eyes are on the Supreme Court, waiting to find out how they are going to rule on the individual mandate contained in the healthcare reform law. The Supreme Court could do a number of things: they could rule the individual mandate is unconstitutional and leave the rest of the bill standing; they could rule the whole thing is unconstitutional and that would result in a lot of changes; or they could rule it constitutional. That's going to be really important and something we are keeping our eye on.
Q: How can ASC administrators, physicians and advocates become involved in lobbying efforts at the national and local levels?
WP: We have a very active grassroots network and we encourage all ASCs to participate. We have weekly updates on the happenings in Washington, D.C., and we would like to see everyone become more involved. People should find out who their members of Congress are so they can meet with them and educate them on the valuable role ASCs play in the healthcare system and in their community. We have staff members here at ASCA who are willing to connect ASCA members with their lawmakers.
Our website has information about how ASC professionals can approach conversations with government officials and develop their relationships with their elected officials. We also have issue briefs on our website on the major issues that impact the ASC industry on Capitol Hill.
Q: Are there any activities going on that would be of interest to particular constituents in the ASC industry?
WP: We recently endorsed a bill that attempts to fix a flaw in the healthcare reform law. There is a provision in the law that entitles Medicare beneficiaries to one free colonoscopy screening without any copay; that's a great provision and we need to encourage more seniors to have colonoscopies. However, the flaw is if they go in for the free colonoscopy and the physician finds something wrong — a polyp or cancer — the screening turns into a diagnostic colonoscopy and the patients are now responsible for the co-pay.
We have endorsed legislation to fix that flaw so patients won't have to receive bad health news and, then, have to make an unexpected out-of-pocket payment. There are several GI groups endorsing and supporting it. The only way we can remedy this flaw is by passing a new law and we hope Congress will act so there isn't a barrier to people receiving their colonoscopy screenings.
More Articles on Surgery Centers:
7 Reasons for Claim Denials in Surgery Centers—and How to Fix the Problem
4 Tactics Payors Use to Drive Surgery Centers In-Network—and How to Respond
When 5010 Implementation Delays Surgery Center Payment: 4 Ways to Respond