May/June Issue of Becker's ASC Review

ON THE COVER

Class action suits look for answers after Laser Spine Institute’s abrupt closure — 7 insights
The ramifications of Tampa, Fla.-based Laser Spine Institute's abrupt closure are vast, with employees and patients searching for answers, the Tampa Bay Times reports.

What a Michigan ASC does to stay competitive & recruit physicians — 3 Qs with Executive Director Tina Piotrowski
Grand Rapids, Mich.-based Metro Health OAM Surgery Center Executive Director Tina Piotrowski, RN, told Becker's ASC Review about her center's market dynamic, competitive strategy and approach to physician recruitment.

Outpatient joint replacements at ASCs cost 40% less than hospital-based surgery: 3 study details
A new study suggests there isn't increased risk for patients undergoing outpatient joint replacements performed in the ASC setting when compared with the inpatient hospital setting, according to new research from New York City-based Hospital for Special Surgery and Philadelphia-based Rothman Orthopaedic Institute.

How much revenue do GIs generate for hospitals? 3 report details
Gastroenterologists generate more net revenue for hospitals than general surgeons, internal medicine physicians and oncologists, on average, according to Merritt Hawkins' 2019 Physician Inpatient/Outpatient Revenue Survey.

In-N-Out Burger’s customer-focused philosophy: 5 things ASCs can learn
In-N-Out Burger, a 70-year-old company that Money Magazine named America's best fast food chain in 2018, has a business model ASCs can learn from, according to Global 1 Co-Principal and Convergent SameDay Orthopedic Strategies Managing Director Scott Leggett.

Vanderbilt hit with $25.5M suit over wrong-site surgery
A Tennessee woman filed a lawsuit against Nashville-based Vanderbilt University Medical Center March 19, claiming surgeons operated on her wrong kidney, reports The Tennessean.

Physicians sue Tenet, Detroit Medical Center, allege cost-cutting led to patients deaths
Two former Detroit Medical Center cardiologists filed a lawsuit March 25 against the hospital and its parent company, Dallas-based Tenet Healthcare, according to the Detroit Free Press.

Total joint replacement in ASCs for 2019
Total joint replacements in ASCs are increasing in popularity and becoming more common. The shift to value-based care, insurance coverage expansion and studies showing good patient outcomes in the outpatient setting are just some of the trends driving total joints to the outpatient setting.

10 states with the most, least Medicare-certified ASCs
California has more Medicare-certified ASCs than any other state, according to the Ambulatory Surgery Center Association. It is the third largest state in the U.S., based on square mileage.

The strategy for 4 ASCs to recruit and retain great staff
Four ASC administrative leaders discuss how they are solving their biggest staffing challenge: recruitment and retention.

ASC MANAGEMENT

Class action suits look for answers after Laser Spine Institute’s abrupt closure — 6 insights
The ramifications of Tampa, Fla.-based Laser Spine Institute's abrupt closure are vast, with employees and patients searching for answers, the Tampa Bay Times reports.

HCA Healthcare recruits 1,000+ displaced Laser Spine Institute employees
HCA Healthcare's West Florida Division in Palm Harbor is extending support to the 1,000-plus employees who lost their jobs when Tampa, Fla.-based Laser Spine Institute discontinued operations March 1.

10 states with the most Medicarecertified ASCs | 2019
California has more Medicare-certified ASCs than any other state, according to the Ambulatory Surgery Center Association. It is the third largest state in the U.S., based on square mileage.

10 states with the least Medicarecertified ASCs | 2019
Vermont is home to even fewer Medicare-certified ASCs than Washington, D.C, which has three, according to the Ambulatory Surgery Center Association.

Increasing Medicare payments, number of ASC openings, closings & more: 48 takeaways from MedPAC report
MedPAC's 2019 commission report to Congress provided insight on a number of ASC metrics, including Medicare payment growth, facility statistics, the number of fee-for-service beneficiaries and service volume, among other metrics.

Capital Ortho opens surgery center on new campus — 4 insights
Madison, Miss.-based Capital Ortho's new Flowood, Miss.-based campus houses the Specialty Surgical Center, Northside Sun reports.

UnitedHealth, Tenet & HCA rank among top 50 largest medical group organizations
The 50 largest medical group parents own and manage about 27,546 medical sites and employ 125,135 physicians, according to IQVIA.

USPI may exceed $175M acquisitions for the right deal + how PE firms become an opportunity, not competition
Dallas-based Tenet Healthcare CEO Ron Rittenmeyer touted the company's financial and cultural change in the company's 2018 earnings call, driven by a strong year from its ambulatory division, United Surgical Partners International, which reported a 7.5 percent net operating revenue increase to $2 billion.

Surgery Partners names new EVP, COO: 5 key notes
Surgery Partners named former Dallas-based Tenet Healthcare leader Eric Evans executive vice president and COO.

New Jersey men plead guilty to defrauding investors in fake ASC – 5 details
In New Jersey, a father and son team pleaded guilty to defrauding investors who thought they were purchasing shares of an ASC, based on a press release from the New Jersey attorney general's office.

Belleville Surgical Center selling 2 centers after hospital opens — 4 insights
Belleville (Ill.) Surgical Center is seeking state permission to sell its two surgery centers in response to declining patient volumes, the St. Louis Business Journal reports.

Humana adds 100+ SurgCenter Development facilities to national network — 3 things to know
Humana and Towson, Md.-based SurgCenter Development entered an agreement adding more than 100 SurgCenter Development locations to Humana's national provider network, effective Feb. 1.

4 ways Apple could transform medical billing
Apple could build upon its health technology and financial services efforts by entering the medical billing space, CNBC reports.

AHA fights site-neutral payments for HOPDs with new study
The American Hospital Association is challenging CMS's 2019 payment reductions to off-campus hospital outpatient clinic visits, and the move toward site-neutral payments, with a new study that claims patients at hospital outpatient departments are poorer and sicker than ASC patients.

The strategy for 4 ASCs to recruit and retain a great staff
Four ASC administrative leaders discuss how they are solving their biggest staffing challenge: recruitment and retention.

Leapfrog launches inaugural ASC quality & safety survey: 5 details
The Leapfrog Group launched a survey evaluating ASC quality and safety April 1.

Brookside ENT and Hearing Center closes after hack deletes all files — 7 insights
Battle Creek, Mich.-based Brookside ENT and Hearing Center closed after the center fell victim to a data hack that wiped out all the practice's files, local news affiliate WWMT reports.

Gastro Health makes 1st out-of-state acquisition in Alabama — 5 insights
Miami-based Gastro Health is acquiring Birmingham, Ala.-based Southeast Gastro, its first out-of-state acquisition.

THOUGHT LEADERSHIP

Cardiac procedures are the ‘total joints of tomorrow’ for ASCs — 3 Qs with Outpatient HealthCare Strategies’ Jessica Nantz
Total joints and cardiac procedures are two of the biggest opportunities for ASCs in 2019, according to Jessica Nantz, president of Spring, Texas-based Outpatient HealthCare Strategies.

How ASCs can compete with hospitals for top talent — 4 expert insights
ASCs should be proactive and sell their strengths to attract the best candidates, according to Liz Bickley, senior vice president of healthcare client services for Cielo, a recruitment process outsourcing company.

How total joints propelled an Ohio-based ASC’s strategy for growth + a bigger location
The Orthopaedic Surgery Center in Boardman, Ohio, is a 100 percent physician-owned facility focused on orthopedics. Here, Administrator Taylor Cera discusses the group's growth and opening a new ASC in 2019.

Private equity, the state of ophthalmology ASCs & more — Dr. Ben Cohen shares his thoughts
Ophthalmologist Ben Cohen, MD, founded New York City-based Retinal Ambulatory Surgery Center of New York in 2010, growing the surgery center into an independent force with more than 30 physicians performing more than 4,000 procedures annually.

How Great Lakes Surgical Center ensures patient responsibility collection on the day of surgery
Administrator of Southfield, Mich.-based Great Lakes Surgical Center Allison Stock, RN, JD, CASC, discusses the center's strategy for patient collections and where she sees payer trends headed in the future.

Emerging spine technologies include smart technologies, robotics & nano-engineering: Q&A with Dr. Frank Shen
Frank Shen, MD, division head for spine surgery at the University of Virginia Health System's department of orthopedic surgery in Charlottesville, discusses the big technology trends in spine surgery that will have an impact on the future.

JOINT VENTURES

6 trends and observations in ASC M&A
There are several players in the outpatient surgery space interested in ASCs.

Syracuse Orthopedic Specialists opening orthopedic surgery center
Syracuse (N.Y.) Orthopedic Specialists will open its 47,000-square-foot Specialists' One-Day Surgery Center in April, moving its outpatient surgical procedures into the center soon after it opens.

Compass Surgical Partners & physicians establish ASC — 5 insights
Raleigh, N.C.-based Compass Surgical Partners formed Tampa, Fla.-based Legacy Surgery Center in partnership with a group of physicians.

Pennsylvania proposes ASC tax again in 2019 — 3 details
Pennsylvania's 2019-20 budget proposal includes a tax on ASCs, according to the Pennsylvania Medical Society.

South Carolina pain group under investigation for billing fraud related to opioids, urine testing — 5 notes
Last October, the FBI raided Spartanburg, S.C.-based Pain Management Associates' offices in three different cities and new documents show the affiliated physicians are under fraud investigation, according to WSPA, which is a CBS affiliate.

Skyline Urology to pay $1.85M over improper billing allegations — 5 details
Skyline Urology in Baltimore agreed to pay the government $1.85 million to resolve allegations it violated the False Claims Act.

Large payers like UnitedHealthcare could buy PE investments in 2nd wave — 4 insights
As the first round of private equity investors prepare to sell, JD Supra examined what the second wave of physician practice management practice buyers could look like.

How 3 ASC administrators deal with the rise in high deductible plans
As more people become covered under high deductible health plans, patients are responsible for paying a larger portion of their medical bill.

Bundled payments in action — ASC bundled payment network saves insurance collective $7M+
Global 1's ASC bundled payment network is paying dividends for the Municipalities Colleges Schools Insurance Group, saving more than $7 million in surgical costs.

CODING & BILLING

NY insurer files suit over $28M in ‘fraudulent and abusive’ claims from ASC, physicians & pain companies: 7 things to know
American Transit Insurance Corp. filed a lawsuit alleging Hackensack, N.J.-based Dynamic Surgery Center, physicians and other related parties submitted over $28 million in "fraudulent and abusive" claims under New York's no-fault coverage system.

Rothman Orthopaedics aims to expand nationally with NueHealth, MUVE joint venture: 5 things to know
Philadelphia-based Rothman Orthopaedics partnered with ASC platform company NueHealth and MUVE Health, a developer and operator of total joint and spine centers, to integrate their models and platforms.

SurgCenter Development forms 200th ASC partnership — Company in 'full-growth mode'
Towson, Md -based SurgCenter Development formed its 200th ASC partnership with SurgCenter of Clearwater (Fla.).

Physician group adds $2.8M ASC to 7-practice portfolio — 1 year ago 'we weren't an entity'
After suing for independence from Atrium Health in 2018, Tryon Medical Partners has opened a $2.8 million gastroenterology facility in Charlotte, N.C., the Charlotte Business Journal reports.

ORTHOPEDICS

How well is Walmart’s spine center of excellence program working? 5 takeaways
Danville, Pa.-based Geisinger joined Walmart's center of excellence network in 2017 for spine surgery, providing Walmart employees access to Geisinger's spine team without additional out-of-pocket costs. A Harvard Business Review article recently outlined the program's success.

Neurosurgeon-generated revenue for hospitals jumps 40.5% in 3 years to $3.4M
Physicians and surgeons generate millions of dollars in revenue for affiliated hospitals each year, with neurosurgeons ranking No. 3 among the top revenue generators, according to a new survey from Merritt Hawkins and AMN Healthcare.

10 things to know about total joint replacement in ASCs for 2019
Total joint replacements in ASCs are increasing in popularity and becoming more common. The shift to value-based care, insurance coverage expansion and studies showing good patient outcomes in the outpatient setting are just some of the trends driving total joints to the outpatient setting.

14 ASCs adding total joint replacements in the past year
ASCs across the country are beginning to incorporate outpatient total joint replacements into existing and new ASC projects.

Innovation in spine will focus on outpatient: Q&A with Dr. Alexander Taghva
Alexander Taghva, MD, of Orange County Neurosurgical Associates in Mission Viejo, Calif., discusses where he sees the biggest impact of spine technology going forward.

Payer to expand bundled payments to Medicare Advantage beneficiaries
UnitedHealthcare will expand BPCI Bundled Payments to include Medicare Advantage beneficiaries in 2020.

Bundled payments can reduce per-patient episode of care costs for total joint patients by $5K+, study finds: 3 details
A bundled payment program can lower 90-day episode of care costs for Medicare patients undergoing total hip and knee arthroplasty, according to research published in the Journal of Arthroplasty.

Smith & Nephew makes 2 acquisitions in 2 days: 6 key points
Smith & Nephew acquired Brainlab's orthopedic joint reconstruction business.

Orthopedic center evacuated after angry former patient shoots ‘several rounds’ outside California hospital: 5 key notes
Around 80 people were evacuated from Eisenhower Health's campus in Rancho Mirage, Calif., after a former patient opened fire just outside of the hospital's orthopedic center, according to the Desert Sun.

Orthopedic surgeon pays $84,666 to settle kickback allegations over pain cream medical directorship arrangement
Brandon Claflin, DO, paid $84,666 to settle allegations of accepting illegal kickbacks in exchange for writing prescriptions.

Humana launches bundled payment for spinal fusions at 4 practices, expands joint replacement program — 6 insights
Humana is expanding its value-based orthopedic care program by offering Humana Medicare Advantage members access to bundled payments for spinal fusion surgery.

Munson Health settles $7M lawsuit with neurosurgeon: 6 things to know
Traverse City, Mich.-based Munson Healthcare settled a $7 million lawsuit filed by neurosurgeon Kenneth M. Louis, MD, according to the Traverse City Record-Eagle.

BPCI Advanced loses 252 providers, 35% of lower extremity major joint replacement participants
The Bundled Payments for Care Improvement Advanced Program saw a 16 percent drop in participants since October 2018, CMS reported.

The spine surgery devices, techniques that won’t stand the test of time
Nine spine surgeons discuss the technology and techniques that will fade over the next few years, and factors driving the disappearance.

Penn Medicine opens $10M spine center with Dr. William Welch as medical director – 4 things to know
Penn Medicine opened a new $10 million spine center at Pennsylvania Hospital, both based in Philadelphia.

Dr. Todd Albert to complete surgeon-in-chief term in June, maintain spine practice at Hospital for Special Surgery
Todd Albert, MD, will conclude his term as surgeon-in-chief and medical director of New York City-based Hospital for Special Surgery in June, and orthopedic surgeon Bryan Kelly, MD, will succeed him.

Dr. Daniel Birk’s bold prediction: Spinal fusion will become mostly obsolete in 10 years
Daniel Birk, MD, director of the Neurosurgery Spine Center at Stony Brook (N.Y.) Medicine, discusses the biggest challenges and opportunities in spine device development today.

11 big acquisitions for spine, orthopedic device companies in 2019 so far
Here are the big acquisitions in the orthopedic and spine device space announced so far in 2019.

Spinal fusion hospital costs for Medicare patients exceed $40K: 5 things to know
In a study presented at the North American Spine Society Annual Meeting last September, Kevin McGuire, MD, of Lebanon, N.H-based Dartmouth-Hitchcock Medical Center shared findings on hospital costs for spinal fusion patients, according to AAOS Now.

DePuy claims Orthofix compelled sales reps to break contracts — 5 lawsuit details
Orthofix allegedly persuaded employees to break their contracts with DePuy Synthes, damaging the latter's ability to conduct business in Texas and Alabama, according to a lawsuit filed Feb. 14.

SPECIAL

310 ASCs with total joint replacements | 2019310 ASCs with total joint replacements | 2019
Total joint replacements are moving to the outpatient setting, with more than 300 ASCs across the country including total knee and hip procedures.

GASTROENTEROLOGY

3 study insights into the best bowel preparation solutions
A study published in the American Journal of Gastroenterology compared what bowel preparations were best tolerated and most effective.

Colonoscopy the gold standard in US, despite alternatives — 7 insights
Medscape reviewed current colorectal cancer screening tests options as well as research surrounding them to quantify which is the most effective.

AI-assisted colonoscopy improves polyp, adenoma detection — 5 study insights
A study published in Gut analyzed the effectiveness of Shanghai Wision AI's artificial intelligence-based computer aided detection system, which found significantly more adenomas and polyps than standard colonoscopy alone.

Gastro Health acquiring Gastroenterology Specialists, continuing Florida expansion efforts — 4 insights
Miami-based Gastro Health entered into an agreement to acquire Longwood, Fla.-based Giles Gastroenterology Center, doing business as Gastroenterology Specialists.

PE groups eye Peak Gastroenterology Associates — 4 insights
The gastroenterology space may soon have its fourth private equity investment as Colorado Springs, Colo.-based Peak Gastroenterology Associates retained a financial consultant, PE Hub reports.

4 trends to know about private equity in gastroenterology — Multiples, market potential & more
High gastroenterology private equity activity will continue in 2019, according to Kerri Zelensek, McGuireWoods associate, and Tom Zahn, partner at McGuireWoods. Mr. Zahn and Ms. Zelensek attended the 6th Annual Healthcare and Life Sciences Private Equity and Finance Conference, February 20 and 21 in Chicago, and outlined the key takeaways on JDSupra.

QUALITY

60 patients sue Guardian Pharmacy & 2 Dallas surgery centers that used its drug: 5 insights
Sixty patients are suing Dallas-based Guardian Pharmacy and two Dallas-area surgery centers that administered the company's compounded solution in 2016 and 2017, WFAA reports.

Preoperative frailty assessments in ASCs — 5 insights from anesthesiologist Dr. Lee Fleisher
Lee A. Fleisher, MD, is chair of Philadelphia-based University of Pennsylvania Perelman School of Medicine's anesthesia and critical care departments. Dr. Fleisher is also chair of the American Society of Anesthesiologists Perioperative Brain Health Initiative.

Columbia Surgical Specialists of Spokane pays nearly $15K to resolve ransomware attack affecting 400,000 patients: 4 details
Columbia Surgical Specialists of Spokane (Wash.) reported a ransomware attack affecting 400,000 patients to the HHS' Office for Civil Rights Breach portal Feb. 18.

Colorado anesthesiologist’s license suspended after allegedly obtaining opioids illegally — 4 insights
Colorado Springs, Colo.-based anesthesiologist Agnes Flaum, MD, faces criminal charges after allegedly obtaining opioids illegally, The Gazette reports.

HEALTHCARE NEWS

CEO of U of Maryland Medical System to take leave of absence amid scandal
The president and CEO of Baltimore-based University of Maryland Medical System agreed to take a leave of absence, effective March 25, amid a scandal involving business deals between the system and several of its board members, according to The Washington Post.

The 6 specialties osteopathic physicians opted for on match day
The American Osteopathic Association shared results from its 2019 AOA Match, which saw more than 500 osteopathic physicians placed into residency programs.

Physicians sue Tenet, Detroit Medical Center, allege cost-cutting led to patient deaths
Two former Detroit Medical Center cardiologists filed a lawsuit March 25 against the hospital and its parent company, Dallas-based Tenet Healthcare, according to the Detroit Free Press.

Patient sues Northwestern Medicine after medical records posted on social media
A patient at Winfield, Ill.-based Northwestern Medicine Regional Medical Group is suing the health system and a former employee for allegedly accessing her medical records and posting them on social media, according to CBS Chicago.

Missouri Supreme Court finds ASC wasn’t negligent in credentialing surgeon that didn’t disclose lawsuits – 4 key notes
Earlier this week, the Missouri Supreme Court decided a surgery center wasn't liable for approving staff privileges for a surgeon with undisclosed lawsuits against him, according to a Kansas City Business Journal report.

CHS made false meaningful use claims, whistleblowers say
Whistleblowers allege Franklin, Tenn.-based Community Health Systems submitted hundreds of millions of dollars in false claims to HHS for federal incentive payments through CMS' promoting interoperability program for EHRs, according to court documents unsealed March 14 in Miami.

New York hospital settles with Cerner over billing problems: 5 things to know
Glens Falls (N.Y.) Hospital has reached a settlement with Cerner over losses it sustained when Cerner's billing system did not work, according to The Post-Star.

Texas hospitals record most cyberattacks in US
Since 2014, more than 1.4 million Texans have had their health records stolen, making hospitals in the state most at-risk for cyberattacks, according to data from HHS and cited by Texas Public Radio.

CEO of Connecticut hospital defends $1M salary: ‘People don’t understand what it actually takes to get into this role’
Bristol (Conn.) Hospital CEO Kurt Barwis and several hospital board members discussed the institution's robust C-suite compensation packages in light of a state tax revenue proposal, according to HartfordBusiness.com.