From: Becker Scott <>
Subject: [Becker's ASC E-Newsletter] CME Credits Audio Conference Announced for March 19 -- Handling Complex Orthopedic and Spine Cases in ASCs; ASCs Reeling From Change in Humana Fee Schedule
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February 7, 2008
In This Issue
Handling Complex Orthopedic and Spine Procedures in an ASC -- An Audio Conference
ASCs Reeling From Change in Humana Fee Schedule
News and Notes
Companies to Watch
May-June issue promo
Handling Complex Orthopedic and Spine Procedures
in an ASC -- An Audio Conference

DATE:       Wednesday, March 19, 2008     

TIME:        2 p.m. Central
LENGTH:    60 to 90 minutes     


  • which spine procedures can be safely and properly performed in an ASCr;

  • which knee, hip and shoulder procedures can and can't be performed in an ASC;

  • how to assess patient selection criteria for spine and advanced orthopedic procedures;

  • how to determine which special safety procedures an ASC should have in place as it handles more complex spine and orthopedic procedures; and

  • the requirements for reimbursement for more advanced spine and orthopedic procedures.

SPEAKERS:   Dr. John Caruso
                      Dr. Philip A. Davidson
                      Mr. Jeff Leland

    Orthopedic Physicians     Neurosurgeons
    ASC Administrators         ASC Directors of Nursing
    Medical Directors            Anesthesiologists


  • 1.5 - Earn CME Credits

  • 1.5 - Earn AEU Credits


  • Dr. John Caruso regarding spine procedures in an ambulatory surgery center. He has more than 16 years of neurological surgery experience. Since completing residencies at the Eastern Virginia Graduate School of Medicine and the University of New Mexico, Dr. Caruso has been in private practice with Neurosurgical Specialists in Hagerstown, Md. Dr. Caruso received his MD from the Eastern Virginia Medical School in 1990. He is board certified by the American Board of Neurological Surgery and licensed in Maryland, West Virginia, and Pennsylvania. He is a member of the Congress of Neurological Surgeons.

  • Dr. Philip A. Davidson regarding advanced orthopedic procedures in an ambulatory surgery center. Dr. Davidson practices orthopedic surgery in Florida, where he is the founder and CEO of Tampa Bay Specialty Surgery Center. He specializes in cartilage restoration and shoulder surgery, with extensive experience in the area of tissue transplantation, including allografts, xenografts and the usage of autologous growth factors.   He is an internationally recognized surgical educator, clinical and basic science investigator, and a widely published scientific author. He is He is on the clinical faculty of the University Of South Florida College Of Medicine and he is a fellow of the AAOS, ABOS, AANA, AOSSM, ISAKOS, the International Patellofemoral Study Group and the International Cartilage Repair Society. Dr. Davidson also is a Partner of Nascent Enterprises, a medical device venture catalyst firm that provides strategic advisory and financing services to numerous medical device clients and portfolio companies. Dr. Davidson graduated from Harvard College, magna cum laude, and Cornell Medical College, with honors in research. He completed his orthopedic training at Baylor College of Medicine, with a fellowship in sports surgery at the Kerlan-Jobe Orthopedic Clinic.

  • Jeff Leland, CEO of Blue Chip Surgical Partners, regarding reimbursement for more advanced procedures. Mr. Leland served as executive director, Lutheran General Medical Group, a 260-physician, multi-specialty medical group located in Chicago. Jeff was once a senior-level executive with Advocate Health Care in Chicago, responsible for both Business Development and Advocate's 225,000-member health plan. He also served as President of HealthSpring Medical Group, a primary care medical group that was acquired by Met Life & Travelers, and as CEO of Western Ohio Health Care, an HMO with 200,000-plus members, which was acquired by United HealthCare. He is an alumnus of the Harvard Business School with undergraduate studies at the University of Cincinnati.

CME Credits:    1.5 CME credit; 1.5 AEU credit

This CME activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) thru the Joint Sponsorship of the Institute for Medical Studies (IMS) and ASC Communications Inc. IMS is accredited by the ACCME to provide continuing medical education for physicians. IMS designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nurses may claim credit for activities approved for AMA PRA Category 1 Credits in most states, for up to 50% of the nursing requirement for recertification.

Registration is limited to 60 attendees.

4 Easy Ways to Enroll

Make checks payable to ASC Communications.

Special Offer: Conference attendees can sign up for a one year subscription to Beckers's ASC Review for just $100 -- a $99 discount off the regular annual subscription fee of $199.


ASC Communications Audio Conference: Handling Complex Orthopedic and Spine Procedures in Ambulatory Surgery Centers

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________ Audio conference only ($199)
________ Special offer: one-year subscription to Becker's ASC Review ($100)

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ASCs Reeling From Change in Humana Fee Schedule

Citing the Center for Medicare and Medicaid Services' new ASC payment system, which took effect Jan. 1, Humana has cut ASC reimbursement rates by 10 to 15 percent in southwestern Ohio.

"We, of course, had no problems with a switch in methodology, but when we ran Humana's proposed rates and we found out that Humana appeared to be using the Medicare payment methodology switch as an opportunity to reduce reimbursement to ASCs in 2008, we were greatly alarmed," says Donald Jansen, MHA, the vice president of marketing and development for Prexus Health, which operates four ASCs in the area.

According to Prexus, Humana sent communication on Oct. 1 to ASCs in the region to inform them it would be changing its fee schedule for care delivered in the ASC setting effective with the new year, coinciding with Medicare's switch from grouper-based reimbursement to a percentage of HOPD reimbursement. Further, Humana's actions seem to be an attempt to gain favor with hospitals at the expense of subscribers and providers - an allegation a Humana spokesman says is untrue.

"In this situation, Humana is willing to move care to a more expensive locale despite excellent patient satisfaction marks and despite very high physician satisfaction levels," says Mr. Jansen. "As well, Humana is setting this policy at a time when its profits, employer premiums and employee deductibles continue to increase. For the last few years, southwestern Ohio has enjoyed for the most part collaborative relationships with its major insurers. Humana's most recent policy decision has confused many of us and, more importantly, Humana has adopted a take-it-or-leave-it attitude."

Prexus says it will be forced to withdraw from Humana's network effective March 31 if no resolution is reached. For its part, the insurer is confident a compromise will be reached. "Only Prexus and one independently run ASC have expressed concern," says Jeff Blunt, the media relations manager at Humana. "We have a very strong belief the way to go about this work is collaboratively. Deals almost always get done, and it's very rare to see network disruption."

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News and Notes

GAO finds FDA inspections of medical device manufacturers lacking. The FDA is not meeting the statutory requirement to inspect certain domestic manufacturers of medical devices, and inspections of foreign manufacturers are lacking, according to a GAO report released earlier this week. Manufacturers of high-risk devices, such as implants, and medium-risk devices, such as hearing aids, are not being inspected every two years; the FDA estimates every three years for high-risk, and five for medium. While there is no comparable requirement to inspect foreign manufacturers, FDA officials estimate they are inspecting high-risk establishments once every six years, and medium-risk once every 27. Further, inspections conducted through the FDA's two accredited third-party inspection programs, meant to boost FDA efforts, are sparse: Just five such inspections have occurred from March 11, 2004, to Jan. 11, 2008. Overall, writes the GAO, "the small number of inspections ... raises questions about the practicality and effectiveness of establishing similar programs that rely on third parties to quickly help FDA fulfill its responsibilities."

Becker's ASC Review special offer. The Becker's ASC Review is published six times a year. To receive a hard copy delivered and never miss an issue, subscribe. As a special introductory offer, the next 100 new subscribers can subscribe for two years for $199 -- a discount of $100 off the usual $299 price. To subscribe, either fax this form to (866) 678-5755 or mail to ASC Communications, 315 Vernon Ave., Glencoe, IL 60022. Please mark on the subscription form "special offer -- $199." Subscription forms must be received by Feb. 20.

As a bonus, each subscriber will also receive a PDF version of the entire and extremely useful useful VMG Health Intellimarker, the single best benchmarking resource. Please call (214) 369-4888 for more information on VMG Health, a leading healthcare valuation firm.

Exhibit space for June orthopedic-drive conference going fast. For the June Orthopedics-, Pain Management- and Spine-Driven ASC Conference, more than half of all exhibit booths are now reserved. If you want to reserve space, please contact Jessica Cole or Dan Bragaw. You can also print out a prospectus for the conference at

The following sponsorships have been reserved for the conference. Thank you to these sponsors; they will get great exposure to hundreds of ASCs, physicians, administrators and others.

  • Senior Leadership: VMG Health

  • Friday Networking Reception: Symbion

  • Tote Bags: Surgery Consultants of America

  • Badge Lanyards: Eveia Health

  • Conference at a Glance: National Surgical Care

  • Friday AM Networking Break: Facility Development & Management

  • Labeled Botteled Water: Foundation Surgery Affiliates

There are a few sponsorships still available:

  • Senior Sponsorship (1)

  • Keynote Speaker

  • Networking Lunch

  • Networking Reception Thursday

  • Networking Reception 1/2 of Friday

  • Syllabus

  • Thursday Pre-Conference

  • Cyber Cafe

  • Continental Breakfast (2)

  • Networking Breaks (Thursday PM, Friday PM, Saturday AM)

The March/April ad deadline closes Monday. The issue has a terrific internal pull-out section focused on establishing an ASC and terrific articles on GI endoscopy, and on orthopedics and spine. We are investing more and more in outstanding outside writers to ensure we provide the best information in the ASC business. For information on advertising in the March/April issue, e-mail Jessica Cole or e-mail Dan Bragaw.

What's on tap for May/June. The May/June issue of the Becker's ASC Review will feature two core subjects: an ASC's guide to orthopedics and spine (clinical and business issues), and an ASC administrator's guide to anesthesia in ASCs -- a focus on business, clinical and product issues. It will also feature 10 products ASC administrators and medical directors should know about for orthopedics, and 10 they should know about for ambulatory anesthesia. The issue will be distributed at the June conference.

Testimonial -- Meridian
Companies to Watch

We are delighted to highlight the following companies in this week's E-Weekly.

Amkai. Amkai is a software company with 20-plus years of experience delivering administrative and clinical solutions to ASCs, surgical hospitals and physician practices. AmkaiEnterprise is a comprehensive, cost-effective suite providing full facility and clinic management, electronic medical record, CPOE, e-prescription, and related functions designed from the ground up to meet the unique requirements of surgery centers and surgical practices. AmkaiEnterprise manages the workflow and clinical information for nearly all surgical disciplines, allowing organizations to become paperless, reduce cost, improve efficiency, and significantly enhance quality of care. Amkai offers full user training, implementation, integration, and customer support services. Learn more at

The Sanders Trust. The Sanders Trust owns, acquires and develops ASC buildings and medical office buildings nationwide. Owners of ASC "bricks and mortar" who sell their facilities and lease them back from The Sanders Trust benefit by eliminating debt guarantees and freeing capital from an illiquid investment while maintaining control over building management and operation.

Founded in 1997, The Sanders Trust is lead by a 20-year healthcare veteran, CEO Rance Sanders, and by the former Green Bay Packer and NFL Hall of Fame quarterback Bart Starr.

To learn more about how The Sanders Trust can improve your personal balance sheet, visit its Web site, e-mail Bruce Bright or call him at (205) 298-0809 to discuss the sale of your ASC building or MOB.

Ion Healthcare. Ion Healthcare provides a turnkey solution for screening and management of patients with sleep apnea referred to your surgical center. Sleep apnea patients require special care, and Ion can help. The company's clinically proven quality program will provide your center everything needed to assess and manage risks of sleep apnea in patients referred to your center. You do not need to refer away sleep apnea patients. Ion's program provides free on-site clinical support; free sleep apnea screening; at-home diagnostic testing; comprehensive therapy and aftercare programs coordinated with the primary care physician; and a new source of ASC revenue. Contact an Ion Healthcare professional today at (804) 433-1717 or visit Ion Healthcare online to learn how you can partner with the market leader in peri-surgical sleep apnea patient management.

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If you have any questions on any of the items listed in this letter, please contact Scott Becker at (312) 750-6016 or by email at

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