July/August Issue of Becker's ASC Review

ON THE COVER

18-physician group, 2 New York hospitals advance $8M ASC project
Albany (N.Y.) Medical Center, Saratoga Hospital and an 18-physician group gained clearance for their surgery center development, Albany Business Review reports.

How private equity investment affects ASC value & 4 other key trends
ASC valuation multiples are increasing, according to HealthCare Appraisers 2019 ASC Valuation Survey

The state of SurgCenter Development — COO Dr. Greg Fox offers 4 insights
Towson, Md.-based SurgCenter Development started 2019 off in full-on growth-mode, with the company entering into several new partnerships to begin the year.

Where US physicians earned the most in 2018
Total compensation among providers has risen at a rate of 7 percent to 11 percent in the last five years, according to a report from the Medical Group Management Association.

Ohio ASC to close, reopen as joint venture: 4 details
Sandusky, Ohio-based Firelands Regional Medical Center will close its ASC in June and reopen it in collaboration with NOMS Healthcare and Fisher-Titus Medical Center in Norwalk, Ohio, according to the Norwalk Reflector.

Aetna to change ASC payment process — 3 details
Aetna is changing how it will handle certain ASC and ambulatory payment classification code edits, according to AdvantEdge, a medical billing company.

Amulet forms US Digestive Health through PE investment — 5 insights
Amulet Capital Partners formed US Digestive Health, a gastrointestinal-focused practice management organization, through its investment in three Pennsylvania GI practices.

How OptumCare aims to become a $100B business in the next 10 years
UnitedHealth Group plans to grow OptumCare, which includes Surgical Care Affiliates, from a $16 billion business into a $100 billion business, according to the Minneapolis / St. Paul Business Journal.

The outpatient cardiology shift is coming
It's only a matter of time before revenue-generating cardiology cases shift from hospitals to ASCs, a transition that has great implications for Medicare costs, according to Ronald Hirsch, MD, who wrote an analysis on the matter for the Healthcare Financial Management Association.

CMS proposes adding total knee replacements to ASC covered procedures list for 2020, increases payment rates
CMS released its 2020 outpatient and ASC prospective payment system proposed rule, ushering in several changes for ASCs and hospital outpatient departments.

ASC MANAGEMENT

USPI sells 2 ASCs, reports revenue per case up 3% in Q1
Tenet reported its ambulatory care segment revenue dropped 3.6 percent in the first quarter year over year, largely due to the sale of Aspen Healthcare in 2018.

Physician buys 2 Illinois ASCs' assets for $50K after one halts operations
An Illinois partnership shut down Belleville (Ill.) Surgical Center and sold Physicians' Surgical Center to Shakeel Ahmed, MD, after both Belleville-based facilities lost surgeons to local hospital groups.

USPI taps CFO from Goldman Sachs — 4 quick facts
United Surgical Partners International named Owen Morris CFO.

Surgical center building changes hands for $7M
A 22,000-square-foot medical office and surgical center property in Bridgewater, N.J., was sold for $7 million, RISMedia reports.

Buyer pays $15.4M for Kansas ASC — 3 quick points
An Overland Park, Kan.-based medical office building housing Mid-America Surgery Center was sold for $15.4 million.

CHI Franciscan to divest ASC, pay $2.5M to settle lawsuit: 5 things to know
Tacoma, Wash.-based CHI Franciscan agreed to settle a federal antitrust lawsuit related to the acquisition of an orthopedic practice and affiliation with a separate multispecialty physician group that the state's Attorney General deemed anticompetitive, according to the Washington State Attorney General's Office.

How ASC acquisitions may change over the next year
ASC acquisitions may increase over the next 12 months, according to the 2019 ASC Valuation Survey by HealthCare Appraisers.

Physician group's bankruptcy exit, rebuild involves closing surgery center — 4 details
University Physician Group — the faculty practice of Detroit-based Wayne State University School of Medicine — had its reorganization and bankruptcy exit plan approved by the U.S. Bankruptcy Court in Detroit, according to Crain's Detroit Business.

Which states pay GIs the most?
The average annual pay for a gastroenterologist practicing in the U.S. is $347,500, according to jobseeker website ZipRecruiter.

The statistics to know about ASC revenue, out-of-network billing strategy & risk
Out-of-network strategies can affect ASC value, according to the 2019 ASC Valuation Survey by HealthCare Appraisers.

The deal days of summer — Edgemont's Luke Mitchell on the past, present & future of GI PE investment
At the halfway point of the year, private equity investment is still making inroads into gastroenterology. But summer is heating up and with it could come a swell of investment, if momentum continues as planned.

The 10 best, worst states for health system performance
A report from the Commonwealth Fund outlined which states have the best and the worst performing health systems, basing their rankings on health outcomes, health disparities, access and quality of care.

2nd cyberattack at Maryland surgery center affects more than 2,000 patients
Palisades Eye Surgery Center in Bethesda, Md., was hit by a data breach, according to the HHS Office for Civil Rights.

Pennsylvania's $12.5M tax on ASCs could cause dozens to close, lawmaker says — 5 key points
A proposed tax on Pennsylvania ASCs would hurt patients and the practices themselves, according to Pennsylvania state Rep. Greg Rothman, R-Cumberland, who wrote an op-ed to Central Penn Business Journal.

The top, bottom 5 states for RN pay
The average pay for a registered nurse in the U.S. is $68,553, according to a report from job seeker website ZipRecruiter.

Avoid unnecessary rework and expenses by improving the patient registration processes: 5 steps for front-desk staff
With the continued shift of financial liability from the third-party payers to patients, it is critical to have effective, efficient and consistent processes and procedures for patient registration and intake.

THOUGHT LEADERSHIP

Surgery Partners CFO: 5 keys for the future — payer partnerships, future acquisitions & more
Surgery Partners spent much of 2018 shifting strategy to focus on its ambulatory surgery center business instead of its ancillary business, after CEO Wayne DeVeydt came on board in January 2018.

The trend to outpatient surgery, risk-bearing contracts for orthopedic surgeons: Key thoughts from Dr. Louis Levitt
Louis Levitt, MD, is the vice president of Bethesda, Md.-based The Center for Advanced Orthopaedics.

Why ASCs will succeed in value-based care + more insights from a Florida ASC administrator
Consolidation, cost cutting, and efforts to improve efficiency and quality will transform the ASC space within the next 10 years, according to Kerri J. Gantt, administrative director of Gastroenterology Associates of S.W. Florida, a practice based in Fort Myers and Cape Coral.

Woodholme Gastroenterology Associates COO explains patient collections & ASC growth
New technology will spur ASC growth, according to Pamela Isabel, COO of Woodholme Gastroenterology Associates, which operates endoscopy centers and GI practices in the Baltimore area

Core concepts for ASC growth, success today: Q&A with Merritt Healthcare's Matt Searles
Matt Searles, partner at Merritt Healthcare, discusses the big trends and opportunities in the ASC field today.

JOINT VENTURES

25 joint venture ASCs in 2019 — State-by-state breakdown
So far this year, 25 joint-venture partnerships have opened or announced ASCs.

Surgical Care Affiliates plans to add 20 ASCs with value-based growth strategy — 5 insight
Surgical Care Affiliates plans to add 20 ASCs to its portfolio this year, and value-based care is a key part of its growth strategy, SCA Chief Financial Officer Caitlin Zulla told CFO.

13 physicians join 3-way joint venture for orthopedics-focused ASC in Missouri: 5 key notes
Medical Facilities Corp. and NueHealth partnered with St. Luke's Hospital in Chesterfield, Mo., to develop a new ASC.

Atlanta ENT group with 2 ASCs partners with PE firm for regional growth: 5 details
A Chicago-based private equity firm completed a strategic partnership with an Atlanta-based otolaryngology practice that includes seven locations and two affiliated ASCs.

The ASC payer landscape: 4 Qs with Administrator Chris Markford
Chris Markford, administrator of the Orthopaedic Surgery Center of Clearwater (Fla.), shared his thoughts on the top reimbursement trends in the ASC industry.

New Mexico joint venture to open orthopedic ASC — 3 insights
Albuquerque, N.M.-based providers Presbyterian Hospital and New Mexico Orthopaedics are partnering to open a surgical center, local news affiliate KRQE reports.

5 thoughts for a joint-venture ASC + key concepts for building a strong operational structure
Michael Patterson, president and CEO of Mississippi Valley Health in Davenport, Iowa, discusses the key aspects of a successful ASC joint venture.

Augusta University Medical Center buys remaining ASC shares for $2M+ from University Hospital, physicians: 4 details
Augusta, Ga.-based University Hospital plans to sell its stake in an Evans, Ga.-based ASC to an academic medical center, according to the Augusta Chronicle.

CODING & BILLING

The changing bundled payment landscape for ASCs — What to know about risk, payers & future trends
The shift to value-based care and the movement away from fee-for-service payments has spurred growth in the adoption of bundled payment models. CMS and private insurers are focusing on reducing costs while maintaining care quality, paving the way for bundled payment adoption in the healthcare system.

Key trends in ASC payer policy, reimbursement and out-ofnetwork today
Richa Singh is executive vice president of sales at Collect Rx.

Humana expands total joint, spinal fusion bundles to 15 practices
Fifteen new orthopedic and spine practices are joining Humana's spinal fusion or total joint replacement bundled payment arrangement.

5 interesting ASC company partnerships to know
The ASC industry is expanding in new directions, especially focused on orthopedics and gastroenterology.

Trump administration targets consolidation, cost disparity across sites — 5 takeaways
CMS Administrator Seema Verma said the Trump administration is doubling down on site-neutral payments and reversing previous administrations' policies, claiming they accelerated healthcare consolidation, which in turn stifled competition, hurt independent providers, and hiked up costs.

ORTHOPEDICS

How the anterior hip replacement approach fuels outpatient surgery
Joel Matta, MD, pioneered the anterior approach for total hip replacement in the United States in 1996, is an orthopedic surgeon specializing in hip disorders at The Steadman Clinic in Vail, Colo., and the co-founder and chairman of the Anterior Hip Foundation.

Orthopedics in ASCs: The key trends to drive success in 2019 & beyond
Michael Redler, MD, is a founding partner of The Orthopaedic and Sports Medicine Center in Trumbull, Conn.

San Antonio’s biggest orthopedic group gains financing for 8-OR ASC project
The San Antonio Orthopaedic Group got financial backing to construct a flagship medical office building with a 39,000-square-foot ASC.

Zimmer Biomet pays $4.5M to former orthopedic surgeon whistleblower: 5 details
The former orthopedic surgeon who blew the whistle on Biomet's kickback scheme in Brazil received in excess of $4.5 million for his role in the case, according to the Wall Street Journal.

CMS boosts RVUs for 41 spine procedure codes
CMS retroactively updated the Professional Liability Insurance Relative Value Units for several Medicare procedures, which will have a positive impact on spine surgeons, according to an announcement from the International Society for the Advancement of Spine Surgery.

Orthopedic surgeon pleads guilty to stealing colleague’s DEA number for fraudulent prescriptions: 4 things to know
Chad Poage, DO, pleaded guilty to fraudulently prescribing controlled substances using another physician's Drug Enforcement Administration number, according to the DOJ.

Stryker’s strategy for Mako, K2M, sports medicine going forward
Stryker Vice President and CFO Glenn Boehnlein and Vice President of Strategy & Investor Relations Katherine Owen spoke at the Bank of America Merrill Lynch 2019 Health Care Conference, describing the current state of the company and projections for the future.

SurgCenter building orthopedic ASC, its 5th Michigan facility — 3 details
Alliance Surgery Center will be SurgCenter Development's fifth location in Michigan when construction wraps up in November, according to UpNorthLive.

Former MLB pitcher to use $5.1M settlement over spine surgery complications to fight concurrent procedures: 5 things to know
Former MLB pitcher Bobby Jenks reached a settlement with the spine surgeon who performed a spinal decompression on him that resulted in complications, according to an NBC Sports Chicago report.

Louisiana Spine & Sports physician sentenced to 37 months in prison for Medicare fraud, to pay $254,962
A Louisiana-based pain physician who pleaded guilty to committing Medicare fraud was sentenced to prison and ordered to pay hundreds of thousands of dollars in restitution.

Medtronic strengthens spine portfolio with Titan Spine acquisition: 3 details
Medtronic plans to buy privately owned Titan Spine for an undisclosed sum, according to a May 9 news release.

Medtronic leaves knee, hip market with Responsive Orthopedics divestiture: 5 details
Medtronic plans to divest its orthopedics business after unsuccessful attempts to break into the knee and hip implant arena, according to the Minneapolis / St. Paul Business Journal.

Ortho Rhode Island breaks ground on medical office building with surgery center — 3 insights
Providence-based Ortho Rhode Island, Calspan and the Carpionato Group held a groundbreaking for Ortho Rhode Island's medical office building and surgery center in Warwick, R.I., GoLocal Prov reports.

The next 5 years in spine: 5 surgeons on technology to watch
Five spine surgeons discuss where they expect technology to evolve over the next half-decade.

Omni Orthopedics breaking ground on new surgery center — 5 insights
Canton, Ohio-based Omni Orthopedics will break ground on a surgery center April 27, CantonRep.com reports.

Twin Cities Orthopedics adds Dr. Robert LaPrade — 4 insights
Robert LaPrade, MD, PhD, is leaving Vail, Colo.-based The Steadman Clinic to join Golden Valley, Minn.-based Twin Cities Orthopedics, effective July 1.

Pain management investment firm acquires Texas ASC — 3 things to know
A pain management-focused investment and management company acquired Conroe, Texas-based VIP Surgical Center.

Optum names Daniel Schumacher president, COO in companywide transition
UnitedHealth Group named Daniel Schumacher president and COO of Optum in an organizationwide leadership transition.

Florida passes overnight stays for ASCs, mandates child safety rules — 4 details
A Florida law permitting ASCs to keep patients for up to 24 hours passed June 25.

Johnson & Johnson wins titanium rod product liability suit — 4 insights
A state court unanimously ruled in favor of Johnson & Johnson and DePuy Synthes in a product liability suit over the company's Synthes Matrix Screw Rod System, the Connecticut Law Tribune reports.

OrthoCarolina opens new spine, orthopedics center in North Carolina
OrthoCarolina has opened a new center in Lincolnton, N.C., expanding its services to patients of Lincoln County.

Colorado jury awards $2.8M to paralyzed man after hospital failed to recognize spinal injury
Samuel Chifalo was awarded $2.8 million by a jury after staff at Parkview Medical Center in Pueblo, Colo., failed to recognize his spinal injury during an emergency room visit, reports The Denver Post.

Medtronic cuts senior position amid restructuring
Medtronic's senior director of corporate communications left the company because his position was eliminated, the StarTribune reports.

GASTROENTEROLOGY

To screen or not to screen? 45 is the question
Two gastroenterologists debated the virtues of universally screening patients for colorectal cancer at age 45, per the American Cancer Society's guidelines, Medpage Today reports

PE firm invests in 3 Pennsylvania GI practices, forms US Digestive Health
Amulet Capital Partners formed US Digestive Health, a gastrointestinal-focused practice management organization, through its investment in three Pennsylvania GI practices.

3 key ways gastroenterologists can avoid burnout
Gastroenterologists are more prone to burnout than other physicians, according to Joseph C. Anderson, MD, of the Hanover, N.H.-based Dartmouth College Geisel School of Medicine. Dr. Anderson and Carol A. Burke, MD, of the Cleveland Clinic spoke at the American Gastroenterological Association's symposium on physician burnout earlier this month.

The ASC management strategy that will likely lead to failure — 3 expert insights
Successful ASC leadership requires flexibility, responsiveness and talent retention, according to Greg Zoch, partner at Kaye/Bassman International and managing director of the ambulatory surgery and surgical hospital practice.

Mayo Clinic opens new spaces in gastroenterology center — 3 insights
Rochester, Minn.-based Mayo Clinic opened a gastroenterology center on the Saint Mary's portion of its campus, local news affiliate KIMT reports.

QUALITY

These specialty physicians have the highest net worth
Gastroenterologists top the list of physicians with a net worth over $5 million, according to a report from Medscape

4 things to know about ophthalmologist workload
Reimbursement, rules and regulations are some of the top challenges faced by ophthalmologists in 2019, according to Medscape.

HCA Healthcare affiliate acquires supply chain management company — 4 insights
HealthTrust acquired Resource Optimization & Innovation, a supply chain management company, and will now take over group purchasing operations.

Bill to repeal physicianowned hospital ban introduced in U.S. House
A bipartisan bill to repeal the Affordable Care Act's moratorium on new physician owned hospitals was introduced June 4, according to InsideHealthPolicy.

Illinois ASC owner sues generic drug companies: 3 details
A Southern Illinois physician is suing McKesson Corp. and other general drug companies, accusing them of colluding to fix prices for their drugs, according to local ABC news affiliate WSIL-TV.

HEALTHCARE NEWS

Cardiologists warned UNC Children’s of heart program issues
Cardiologists at UNC Children's Hospital in Chapel Hill expressed serious concerns about the safety and quality of the hospital's pediatric heart surgery program in 2016, after noticing an uptick in surgical complications and deaths, according to a 7,000-word investigative report from The New York Times.

UNC Health Care CEO’s memo to staff after NYT exposé
Wesley Burks, MD, CEO of UNC Health Care, sent a five-paragraph email to staff members May 30 in response to an investigative report about the Chapel Hill, N.C.-based system's pediatric heart surgery program, according to NC Health News.

5 biggest GI trends in 2019 — Private equity, salaries, cancer rates & more
As the dog days of summer inch ever closer, here are some of the biggest stories and trends that have defined gastroenterology through the first half 2019.

Covenant Surgical continues acquisition spree with Arizona GI practice
Covenant Surgical Partners entered into a partnership with Phoenix-based Arizona Centers for Digestive Health, adding 11 practices to its portfolio.

Ohio hospital expands orthopedic and sports medicine services
Fairfield (Ohio) Hospital, as part of Cincinnati-based Mercy Health, is set to open its renovated Outpatient Rehabilitation and Therapy center at the end of the month, reports Cincinnati Business Courier.

Highest-paid CEOs in 2018: Who made the list from healthcare
Thirty-two healthcare CEOs made The New York Times and Equilar's 2018 ranking of highest-paid CEOs in 2018.

Beaumont’s CIN to terminate agreement with 2,500-member physician group
Beaumont Care Partners, the clinically integrated network of Southfield, Mich.-based Beaumont Health, will end its agreement with United Physicians, a roughly 2,500-member group also based in Michigan, according to Crain's Detroit Business.

Massachusetts hospital to close in 2020
Union Hospital in Lynn, Mass., will close by May 2020, about eight months later than its expected closure in October 2019, according to CBS Boston.

Supreme Court sides with hospitals in multibillion-dollar payment dispute
In an opinion issued June 3, the U.S. Supreme Court ruled that HHS improperly failed to undergo formal notice-and-comment rulemaking before announcing a new Medicare rate calculation for disproportionate share payments to hospitals.

Why MBA programs are shutting down
A strong job market is suppressing demand for master's in business administration degrees, leading many universities to shutter their in-person programs in favor of online versions, The Wall Street Journal reports.

CMS terminates Kentucky hospital’s Medicare contract
CMS ended its provider agreement with Southeastern Kentucky Medical Center in Pineville on May 24.

Physician compensation grew most for these 5 specialties
Physician compensation increased across the board from 2017 to 2018, with primary care physicians earning a 3.4 percent increase, specialty physicians earning a 4.4 percent increase and advanced practice providers earning 2.9 percent more, according to data from the Medical Group Management Association.

Tennessee hospital to lose Medicare contract
Jamestown (Tenn.) Regional Medical Center is facing financial troubles and is set to see its Medicare and Medicaid funding cut in June, according to The Tennessean.

From cleaners to the top exec, the average salary for 30 hospital jobs
Across the nation's more than 6,000 hospitals, chief executives made an average annual salary of $242,550, compared to phlebotomists, who made an average of $34,750 per year, according to Business Insider.

California hospital CEO gets no-confidence vote from medical staff
Medical staff at St. Mary Medical Center in Long Beach, Calif., part of CommonSpirit Health, unanimously approved a no-confidence vote in the hospital's president and CEO late last month, according to the Long Beach Press-Telegram.

What the average employee made at 30 healthcare organizations
The U.S. requires companies to disclose the median compensation of their employees to shed light on the ratio between the salaries of typical workers and CEOs. Since the requirement was implemented, one thing became apparent: Not all healthcare employees are paid the same.

Massachusetts hospitals stockpile $1.6B in offshore accounts, nurses say
Sixteen hospitals and health systems in Massachusetts have more than $1.6 billion in the Cayman Islands and other tax havens, according to a report issued by the Massachusetts Nurses Association.

Ex-Mount Carmel physician charged with murder of 25 patients
A former physician at Columbus, Ohio-based Mount Carmel Health System, was charged June 5 in the deaths of 25 hospital patients, according to The Columbus Dispatch.