Here are 30 updates for ASC leaders to note from the past month.
DOJ files suit against 2 payer megamergers
The Justice Department's antitrust officials made a much-anticipated move by filing a suit against the pending Anthem/Cigna and Aetna/Humana mergers. Officials say the megamergers would reduce competition, and consumers would bear the burden of the deals — escalated prices.
CMS proposes 1.2% payment increase & 7 new quality reporting measures in 2017 for ASCs
CMS released its 2017 Medicare Outpatient Prospective Payment System proposed rule, which aims to enhance Medicare patients' quality of care. Based on the policy changes in the proposed rule, CMS projects ASC payments would increase 1.2 percent. The seven measures are: ASC-13: Normothermia Outcome; ASC-14: Unplanned Anterior Vitrectomy; and ASC-15(a-e), which includes five measures collected using the Outpatient and Ambulatory Surgical Center Consumer Assessment of Healthcare Providers and Systems survey.
Midwest Orthopaedics at Rush's medical office building, ASC gets green light from village board
The Oak Brook (Ill.) Village Board approved the construction of an outpatient orthopedic care building, which will include an ambulatory surgery center. The new facility is a joint venture between Rush University Medical Center and Midwest Orthopaedics at Rush, both based in Chicago.
Ambulatory Surgery Center at St. Mary suffers data breach affecting 13k patients
After suffering a ransomware attack, Langhorne, Pa.-based Ambulatory Surgery Center at St. Mary sent letters to nearly 13,000 patients whose personal information may have been breached. The ASC discovered the breach on June 1 after staff members noted encrypted files on an internal network.
Cleveland Clinic anesthesiologist Dr. Marc Feldman found dead in motel
Cleveland Clinic anesthesiologist Marc A. Feldman, MD, was found dead in a motel room on June 29. When first responders arrived on the scene, he was not breathing, and he was pronounced dead at the scene.
Yearlong investigation finds 2.4k+ physicians sanctioned for sexually abusing patients
The Atlanta Journal-Constitution conducted a yearlong investigation, which found more than 2,400 U.S. physicians were sanctioned for sexually abusing their patients. AJC's investigation found state medical boards permitted more than 50 percent of the sanctioned physicians to keep their licenses, despite the accusations being proven true.
Industry pays optometrists $18.2M under Physician Payments Sunshine Act
During the first year of mandatory reporting under the Physician Payments Sunshine Act, optometrists accepted cash, cash equivalents or in-kind payments surpassing $18.2 million, $13.2 million of which the industry paid to the top 10 percent of payment recipients. The researchers found the average transaction value reached $111.
Aetna to sell billion-dollar assets to minimize regulatory concerns
To stifle regulatory concerns over its $37 billion Humana merger, Aetna plans to sell billion-dollar assets. Sources claim Aetna and advisers are working on an asset portfolio that could limit any substantial overlap between Aetna and Humana's operations if the assets are divested.
AmSurg's Sheridan acquires AllegiantMD
Sheridan, the physician services division of AmSurg, acquired AllegiantMD, a provider of radiology services in Tampa, Fla. Sheridan's current radiology profile consists of more than 300 radiologists at 150 facilities throughout the United States.
American College of Physicians names AmSurg's Dr. Robert Musselman a fellow
American College of Physicians named AmSurg Partner Robert F. Musselman, MD, a fellow. Dr. Musselman practices at Rockville, Md.-based Endoscopic Surgical Centre of Maryland—North.
SCA partners with Raritan Valley Surgery Center
With this partnership, SCA's New Jersey footprint increases to 13 locations and 19 additional physicians. RVSC is a physician-led surgery center, jointly owned by SCA and physician investors.
MFC pens letter of intent to acquire Unity Medical and Surgical Hospital
Per the letter of intent, Medical Facilities Corp. would acquire an indirect 83 percent interest in the physician-owned medical and surgical hospital. MFC is funding the deal on available cash as well as a draw of MFC's credit facility.
Connecticut co-op faces steep financial troubles, begins 'wind-down' process
After facing financial struggles, Connecticut's co-op, HealthyCT, is under supervision and will start a "wind-down" process. The state said, although it filed a supervision order, HealthyCT's shut down is not definite, and the co-op may cease being under supervision if it does better financially.
Illinois regulator signs order to prevent co-op from paying government
Illinois Department of Insurance Acting Director Anne Melissa Dowling issued an order requesting Land of Lincoln Health, the state co-op, not pay the federal government until the government gives the co-op money owed under the risk-corridor program. Land of Lincoln Health maintains the government owes the co-op almost $73 million under the Affordable Care Act's risk-corridor program.
Illinois co-op Land of Lincoln Health to shut down
After suffering $90 million losses last year, Illinois co-op Land of Lincoln Health is shutting down. The news comes nearly two weeks after Illinois Department of Insurance Acting Director Anne Melissa Dowling issued an order for Land of Lincoln Health to not pay the federal government in an effort to avoid "an immediate liquidation" of the co-op.
Physician dies following attack by patient at Dallas hospital
A patient at 144-bed Timberlawn Mental Health System in Dallas has been charged with manslaughter in the death of a physician he assaulted. The patient attacked Ruth Anne Mardock, MD, Thursday afternoon after Mr. Cason was told he would be transferred to another facility. The patient tackled Dr. Mardock in the hallway outside his room. During the confrontation, which was caught on video, the physician's head hit the floor and she lost consciousness, according to the police documents.
Global endoscopy devices market to reach $36.5B by 2022
The market was valued at $22.6 billion in 2015 and is expected to reach $36.5 billion by 2022. The growing incidence of gastrointestinal conditions and colon cancer as well as the high demand for minimally invasive surgeries will spur the market's growth.
New York regulator 'conditionally' approves Aetna-Humana merger
Sources familiar with the payer matter said New York's insurance regulator conditionally approved the $37 billion Aetna/Humana merger. New York was one of the last U.S. states to approve the deal. An Aetna spokesperson said the payers now have 90 percent of the necessary state approvals.
CMS: Healthcare spending to rise 5.8%
From 2015 to 2025, CMS projects healthcare spending will rise 5.8 percent. While physician and clinical services spending rose 5.4 percent in 2015, medical prices increased merely 0.8 percent last year. Physician prices fell 1.1 percent last year.
CMS open to MACRA delay
In a meeting with the Senate Finance Committee, CMS Acting Administrator Andy Slavitt said the agency would consider delaying Medicare Access and CHIP Reauthorization Act of 2015, which is currently set to take effect on Jan. 1, 2017. CMS is also open to different start dates to allow providers and practices sufficient time to prepare for MACRA.
Physicians fight to retract BMJ medical error study
Two physicians wrote a blog post, arguing the BMJ study represents "a shoddy piece of scientific and statistical work which cannot stand the close scrutiny of peer physician researchers and professional statisticians," and claim the study is not a meta-analysis since researchers derived data from one 2004 Healthgrades study. Retraction opponents claim it is unfair to use the word "meta-analysis," as the Johns Hopkins study authors did not use the term in the paper.
Former Kaiser anesthesiologist claims cost-cutting measures jeopardized patient safety; files lawsuit
Erik Franck, MD, a former anesthesiologist with Oakland, Calif.-based Kaiser Permanente, filed a $9 million lawsuit against the health system. The suit claims Dr. Franck complained about the cost-cutting measures and was later fired.
Gunman kills 2 at Parrish Medical Center
Early Sunday, a gunman entered a patient's room at Parrish Medical Center in Titusville, Fla., and killed an elderly female patient and hospital employee. The attack appears to be random and the suspect is being held without bond on two counts of first-degree murder.
UnitedHealth suffers additional $200M losses
UnitedHealth lost an additional $200 million from the Affordable Care Act exchanges in the second quarter of 2016. However, the payer had 28 percent increase in profits, growing by $10.2 billion compared to the second period last year.
ASGE names Dr. Kenneth McQuaid president
The American Society for Gastrointestinal Endoscopy named Kenneth R. McQuaid, MD, president. Dr. McQuaid is chief of medical service and chief of gastroenterology at the San Francisco VA Medical Center. He is also vice-chairman of the medicine department and a professor at University of California San Francisco School of Medicine.
Humana to leave most ACA exchanges after losing $1B
Humana reported it will leave almost half of the Affordable Care Act's exchanges in 2017 after suffering losses totaling $1 billion last year. The payer said during an earnings report it will participate in "no more" than 11 state marketplaces.
Nobilis names Kenneth Efird president
As president, Mr. Efird will oversee Nobilis' operating units and will lead the execution of the company's strategic plan. Previously, Mr. Efird was the company's chief operating officer and chief business development officer.
Upstate Spine & Neurosurgery Center, Orthopaedic Associates merge to open $7.2M ASC
Two Spartanburg, S.C., practices, Upstate Spine & Neurosurgery Center and Orthopaedic Associates, are opening a physician-owned ambulatory surgery center. The $7.2 million ASC will offer orthopedic surgery, neurosurgery and pain management.
US insurers pay nearly $8k more for TKR than other developed countries
U.S. insurers pay $28,184 to hospitals and physicians for a total knee replacement, nearly $8,000 more than Switzerland payers, which pay $20,132. Leading payers in Spain only pay $6,687. For a total knee replacement, U.K. insurers pay $18,451, New Zealand insurers pay $16,508 and Australian insurers pay $15,941.
Gastroenterologists make $380k annually
Medscape Gastroenterologist Compensation Report 2016 found gastroenterologists earn $380,000, on average, up 3 percent from 2015.
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