March/April 2009 Issue of Becker's ASC Review

11 Key Concepts From Stark Law; 44 ASC Management and Development Company CEOs to Know; 10 Best Practices for Improving GI-Efficiency in ASCs; Publisher’s Letter: Consolidations Increasing - Buyouts Stagnant; 7 Key Legal Areas for 2009; ASC Communications and the ASC Association June Orthopedic, Spine and Pain Management Driven ASC Conference – June 11-13, Chicago Michigan Avenue - $200/$100 Discounts on Registrations Available; 9 Best Practices for Successful Physician/ Hospital Joint-Venture ASCs; Case Study: Successful Joint-Venture Turnaround; 23 Gastroenterologists to Know; 4 Key GI Trends in 2009; 25 Interesting Statistics About Gastroenterology in Surgery Centers; 10 GI and Endoscopy Managed Care Best Practices; 5 Common GI/Endoscopy Coding and Billing Mistakes; 14 GI-Driven ASCs to Know; 8 Devices and Products GI-Driven ASCs Should Know; Should You Sell Your ASC: Assessing Your Value and the Pros and Cons; Establishing an Ambulatory Surgery Center — A Primer From A to Z (Part 1); Industry Leaders Discuss Top Trends in ASC Startups.

February 2009

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Current Issue Articles


11 Key Concepts From Stark Law
The Stark law prohibits physicians from ordering designated health services for Medicare patients from entities with which the physician, or a family member, has a financial relationship unless an exception applies. This article reviews 11 key concepts under the Stark Law, in the context of changes to the Stark law made by CMS.
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44 ASC Management and Development Company CEOs to Know
Here are 44 management and development company CEOs to know. Note: When a company did not have a CEO, we profiled the individual holding the top leadership position, and limited our profiling to one leader per company.
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10 Best Practices for Improving GI-Efficiency in ASCs
Outpatient GI procedures have taken a big reimbursement hit from Medicare and frequently private payors follow suit with additional cuts. That makes it even more critical for ASCs to focus on internal means of improving quality, efficiency and profitability. Our panel of expert advisors, which includes a gastroenterologist, consultant, ASC development company executive, ASC manager and an endoscopy center nurse and manager, offers these 10 ways to improve efficiency in GI.
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Publisher’s Letter: Consolidations Increasing - Buyouts Stagnant; 7 Key Legal Areas for 2009; ASC Communications and the ASC Association June Orthopedic, Spine and Pain Management Driven ASC Conference – June 11-13, Chicago Michigan Avenue - $200/$100 Discounts on Registrations Available
This letter offers a handful of observations one can make as this year starts to evolve. It discusses three papers which are available upon request. It also provides information about 27 of the 68 sessions and discounts for our June Orthopedic, Spine and Pain Management Driven ASC Conference.
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9 Best Practices for Successful Physician/ Hospital Joint-Venture ASCs
As competition intensifies and reimbursement becomes less certain, hospitals and physicians are increasingly exploring partnering in joint-venture ASCs. Both are finding numerous economic, marketing and clinical reasons to join forces. Hospitals are seeking ways to align incentives with doctors, staunch physician defections and retain the outpatient business increasingly leaving their doors, while pleasing their most loyal physicians. Physicians often seek the access to capital and greater market clout hospitals possess.
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Case Study: Successful Joint-Venture Turnaround
In Aug. 2008, Joseph Zasa, co-founder and managing partner of Woodrum/Ambulatory Systems Development, arrived at the Surgical Center for Excellence in Panama City, Fla. Like many centers, the Surgical Center for Excellence was facing some difficult challenges. It was losing money, around $10,000-$40,000 a week, and the bank was calling the ASC’s loan on Jan. 1, 2009. The business office systems were weak, the center owed money to several vendors and although the physician partners were bringing in patients, there were not enough cases to be profitable.
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23 Gastroenterologists to Know
Fernando Bermudez, MD, FACP, FACG. Dr. Bermudez is currently the medical director of the Eastside Endoscopy Center and a physician with G.I. Medicine Associates, both located in St. Clair Shores, Mich. He specializes in diseases of the gastrointestinal tract, the liver and pancreas with special interest in inflammatory bowel disease and motility disorders of the esophagus. A native of Bogota, Colombia, Dr. Bermudez received his medical degree from Javeriana University in Bogota and completed his training at St. John Hospital in Detroit. He completed his fellowship in gastroenterology at Michael Reese Medical Center in Chicago.
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4 Key GI Trends in 2009
This is an exciting time to be in the endoscopy center business. Although there are many pressures on the industry, there are also some terrific opportunities to be gained by the consistent focus in a few key areas. Below are four key trends we at Physicians Endoscopy see for 2009, along with some helpful hints to improve your practice and center.
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25 Interesting Statistics About Gastroenterology in Surgery Centers

1. Gastroenterology was the most common specialty of single-specialty surgery centers in 2008, representing 28 percent of all ASCs.

2. GI practices in multi-specialty centers performed the highest number of procedures annually with an average of 3,710. In single-specialty centers, this number was higher, with an average of 5,379 cases annually.

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10 GI and Endoscopy Managed Care Best Practices
Over the past several years, GI and endoscopy services have been targeted for decreased reimbursements. Already a high volume specialty, it is anticipated that utilization will continue to increase as baby boomers become Medicare beneficiaries. In spite of lowering reimbursements, incorporating a best-practice approach to managed care can lead to ongoing success when providing GI and endoscopy services.
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5 Common GI/Endoscopy Coding and Billing Mistakes
1. Control of bleeding not separately billable. The control of bleeding is included in biopsy (and most other) endoscopic procedures, and is not separately billable unless the patient comes into the facility with a GI bleed, which is the reason the procedure is being performed – which rarely occurs in the ASC setting.
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14 GI-Driven ASCs to Know
A successful ASC requires the cooperation of all members of its staff — from physicians to administrators to nurses and ancillary staff. In the field of gastroenterology, this sense of teamwork permeates through flourishing centers.
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8 Devices and Products GI-Driven ASCs Should Know
Susan Curran, a nurse and manager of the Merrimack Valley Endoscopy Center in Haverhill, Mass., and James Reichheld, MD, a gastroenterologist and director of the Northeast Endoscopy Center in Lowell, Mass., offer their advice on products they say add value to their centers and improve quality and efficiency.
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Should You Sell Your ASC: Assessing Your Value and the Pros and Cons
Thinking of selling a piece of your ASC? There are certainly a number of advantages to aligning with a corporate partner: professional management, access to capital, greater focus on growth and realizing a return on your investment. If these benefits pique your interest, the first step is to assess the value of your ASC. This article explores the various stages in the life of an ASC, along with the pros and cons of selling equity shares to a management company or corporate partner during these various stages.
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Establishing an Ambulatory Surgery Center — A Primer From A to Z (Part 1)
This article summarizes several issues that are critical to establishing an ASC. The article focuses on business and planning issues and does not focus on legal and regulatory issues for ASCs. In addition, industry experts offer their advice on some of these areas.
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Industry Leaders Discuss Top Trends in ASC Startups
We surveyed several ASC management and development companies to get their observations and opinions on the current trends and developments in de novo (startup) ASCs
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