September/October Issue of Becker's ASC Review

ON THE COVER

Tenet/USPI ambulatory revenue up 5.3% in Q2 — 6 things to know
Tenet's ambulatory care segment revenue increased 5.3 percent year over year in the second quarter of 2019, the company reported on Aug. 5.

4 quotes from HCA Healthcare CEO Sam Hazen on outpatient caseload
HCA Healthcare grew its outpatient caseload 3 percent year over year in the second quarter of 2019, which contributed to the company posting $12.6 billion in revenues for the quarter.

Optum adds new partnership model to outpatient strategy with latest health system deal - 3 insights
Eden Prairie, Minn.-based Optum has broken from its pattern of acquiring physician practices, outpatient clinics, urgent care facilities and surgery centers with plans to take over John Muir Health's non-clinical functions, according to Forbes contributor Bruce Japsen.

Meet the head neurosurgeon for Elon Musk’s Neuralink, Dr. Matthew MacDougall
Tesla founder Elon Musk hired Matthew MacDougall, MD, a practicing neurosurgeon, to participate in a new project to develop a brain-computer interface technology and advance treatment for brain disorders, according to the Wall Street Journal.

The 5 states most & least likely to face a physician shortage
States in the West and South may be more likely to face a physician shortage than those on the East Coast, according to a survey by the Senior List cited by Merritt Hawkins.

CMS may pay for total knees, 6 heart procedures at ASCs in 2020
CMS released its 2020 outpatient and ASC prospective payment system proposed rule, ushering in several changes for ASCs and hospital outpatient departments.

ASC revenue cycle, revisited - best ideas today
Revenue cycle management is a crucial aspect of running a successful ASC.

Physicians Endoscopy, Capital Digestive Care team up to create management platform
Physicians Endoscopy and Capital Digestive Care entered into a strategic partnership Aug. 1, which saw the two companies form a management platform.

ASC MANAGEMENT

New York imposes stricter policies for freestanding ASC developments — 5 things to know
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ASCs in New York are subject to a new certificate of need policy, according to law firm Garfunkel Wild.

The top 8 uses of telehealth in the outpatient setting
Over 44 percent of outpatient practices said they use a telehealth solution or service, according to the 2019 outpatient telehealth study conducted by data analytics company Definitive Healthcare.

Independent Texas surgical practice could close after 3 surgeons leave — 4 insights
Three surgeons at Victoria (Texas) Surgical Associates are leaving the practice, the Victoria Advocate reports.

Surgical company seeks $15M investments for 10 closed surgery centers
Worldwide Surgical Solutions, a company that designs and builds surgical facilities, is seeking investors for 10 surgery centers in Texas that have closed down, according to CEO James Hamilton.

Physicians’ top investing mistakes
Medscape outlined the top investing mistakes physicians make and how they can avoid them.

Physician-owned micro-hospital to open in Oklahoma — 3 details
Tulsa (Okla.) ER and Hospital, a physician-owned micro-hospital, is opening its doors to patients July 29, according to local news station ABC 8 Tulsa.

Solving the opioid problem in ASCs — 11 leaders discuss strategies
ASCs are well-positioned to lead the fight against opioid abuse. Here, 11 ASC administrators and thought leaders from across the U.S. discuss how their centers reduce opioid use and improve pain management.

4 essential elements of an ASC total joint program
Andrea Lessner, BSN, RN, total joint coordinator of Scottsdale, Ariz.-based North Valley Surgery Center — an HonorHealth affiliate managed by Sovereign Healthcare — told Becker's ASC Review about four key elements of a successful outpatient total joint program.

THOUGHT LEADERSHIP

Private equity, physician-owned centers & more: Dr. Michael Rivers on ASC trends
Michael Rivers, MD, director of EMA Ophthalmology for EHR developer Modernizing Medicine, weighed in on the key ASC trends this year.

The trends ASCs should know in outpatient orthopedics & other thoughts from Dr. Louis Levitt
Louis Levitt, MD, vice president and secretary of the Centers for Advanced Orthopaedics in Bethesda, Md., spoke to Becker's ASC Review about his thoughts on the recent proposal from CMS, trends in outpatient orthopedics and more.

Why ASCs should be cooperating & not competing: 5 Qs with Jeffrey Flynn, COO & administrator of Gramercy Surgery Center
Jeffrey Flynn is the administrator and COO of Gramercy Surgery Center in New York City, and serves as vice president of the New York State Association of Ambulatory Surgery Centers.

Dr. Michael Weinstein: How drug pricing legislation can hurt patients, independent physicians
Counting drug coupons as part of a drug's added sales price could tie the hands of independent clinicians trying to ensure patients get access to affordable and effective care options, said Michael Weinstein, MD.

The future of cardiology in ASCs: Physicians Surgery Centers’ Jeff Dottl weighs in
Jeff Dottl is a principal for Physicians Surgery Centers, a professional ASC management and development
company.

An election won’t solve healthcare’s biggest problem, says former Sen. Bill Frist
Former Republican senator for Tennessee Bill Frist, MD, offered his opinion on the biggest issue threatening healthcare today and elaborated on what the electorate wants from legislators going into the 2020 election.

JOINT VENTURES

California ASC property sells for $13.5M — 5 details
Forest Surgery Center’s medical office facility in San Jose, Calif., changed hands for $13.5 million, according to commercial real estate news outlet RENTV.

Surgery Partners to relocate multispecialty ASC — 3 details
Brentwood, Tenn.-based Surgery Partners is getting ready to open a new ASC, according to Brian Blankenship, vice president of facility development.

Summit Orthopedics property sells for $29.4M
Summit Orthopedics property sells for $29.4M Summit Orthopedics’ surgery center building in Eagan, Minn., was sold for $29.4 million.

Hartford HealthCare plans $5.5M multispecialty ASC
A $5.5 million ASC addition is in the works for a Hartford HealthCare facility in Plainfield, Conn., according to the Hartford Business Journal.

Private equity-backed company invests in 2 Louisiana eyecare practices
EyeSouth Partners, a private equity-backed management company, has partnered with eyecare practices Eyecare Associates in Metairie, La. and Lanoux & Associates in New Orleans.

Telemedicine company CEO pleads guilty in $424M fraud scheme
The owner and CEO of a telemedicine company pleaded guilty Sept. 6 for his role in a $424 million fraud scheme, which is part of one of the largest healthcare scams ever prosecuted by the Department of Justice.

UPMC's 24-member board faces criticism over management of nonprofit
UPMC's board of directors are facing ongoing criticism over how they manage the nonprofit health system's charitable assets, according to the Pittsburgh Post-Gazette.

Yearly salary ranges for 3 medical professions
PayScale reports real-time salary data from over 54 million reports from job seekers, fact -checking the data against private and public compensation data.

CODING & BILLING

CMS could add 6 heart procedures to ASC-payable list
CMS proposed adding six coronary intervention procedures — including cardiac stenting — to the list of payable surgical procedures at ASCs in 2020.

CVS to launch pilot program for Aetna beneficiaries undergoing total knee replacement surgery
CVS plans to launch a pilot program this summer to help Aetna knee replacement surgery patients with care before and after their procedures, an Aetna spokesperson confirmed to Becker’s ASC Review.

ICD-11 is looming — 8 steps to prepare
The newest version of the International Classification of Diseases, ICD-11, is set to take effect in January 2022, according to Software Advice, a business solutions company.

CMS may require hospitals to post price, payer negotiated rates online — what does it mean for ASCs?
The CMS Medicare Outpatient Prospective Payment System 2020 proposed rule included a requirement for hospitals to publish standard prices and payer-specific negotiated rates.

AMA releases 394 code changes for 2020 — 3 things to know
The American Medical Association unveiled the 2020 Current Procedural Terminology code set, which includes 394 changes to CPT codes and descriptors.

ASC revenue cycle, revisited – best ideas for meeting benchmarks from 3 administrators
Revenue cycle management is a crucial aspect of running a successful ASC.

Minnesota Hospital Association challenges Blue Cross policy shifting services to ASCs
The Minnesota Hospital Association is accusing Blue Cross Blue Shield of Minnesota of breaking the law through policies that limit access to colonoscopies and other services in hospitals in favor of having them in lower-cost settings, like ASCs, according to a letter from the association cited by the Minneapolis StarTribune.

Delaware pain physician indicted in $12.7M Medicare fraud scheme: 4 details
The Department of Justice unsealed an indictment against a Wilmington, Del.-based pain physician for allegedly participating in a scheme to defraud Medicare of millions of dollars.

Optum adds new partnership model to outpatient strategy with latest health system deal — 3 insights
Eden Prairie, Minn.-based Optum has broken from its pattern of acquiring physician practices, outpatient clinics, urgent care facilities and surgery centers with plans to take over John Muir Health’s non-clinical functions, according to Forbes contributor Bruce Japsen.

3 key ways to improve revenue cycle performance
Revenue cycle performance is key to running a successful practice, according to medical news site Mnet News.

Trinity Health sues anesthesia provider embroiled in rate disputes with big payers — 4 details
Trinity Health is suing Anesthesia Associates of Ann Arbor (Mich.) — its exclusive anesthesia provider — in Michigan federal court.

ORTHOPEDICS

Starting pay rises for most specialists, including orthopedic surgeons — 17 statistics
Most specialties saw a year-over-year increase in average starting salary, according to Merritt Hawkins' "2019 Review of Physician and Advanced Practitioner Recruiting Incentives."

Cleveland Clinic delays plans for $30M Florida neurosciences center after finalizing merger — 4 insights
The Cleveland Clinic pushed back plans to build a $30 million Neuroscience Center of Excellence near Port St. Lucie, Fla.-based Tradition Hospital, until after it finalizes its absorption of Martin Health, the TCPalm reports.

Regent Surgical Health, Conformis partner to cut ASC joint replacement costs
Medical technology company Conformis has entered into a partnership focusing on outpatient joint replacements with ASC developer Regent Surgical Health.

Top 20 hospitals for orthopedics, by US News
U.S. News & World Report published its Best Hospitals for Orthopedics 2019-20 rankings, with Hospital for Special Surgery ranking No. 1 for the 10th consecutive year.

Orthopedist salary, revenue generated & demand: 3 notes from Merritt Hawkins
Orthopedists have one of the highest starting salaries for physicians, and generate over $3 million for hospitals, according to surveys conducted by physician search firm Merritt Hawkins.

CMS total joint proposal 'better late than never,' CMO says
CMS' proposal to add total knee arthroplasty to the ASC covered procedures list in 2020 is "long overdue," according to Michael Gillman, MD, CMO and founder of Las Vegas-based BullsEye Ortho.

Orthopedic ASC embarks on $4M expansion, renovation
Raleigh, N.C.-based Triangle Orthopaedics Surgery Center has an expansion in the pipeline, according to documents filed by the North Carolina Department of Health and Human Services.

California hospital to end orthopedic services amid financial constraints: 5 things to know
King City, Calif.-based Mee Memorial Healthcare, a critical access hospital, has eliminated orthopedic services due to financial difficulties.

Meet the head neurosurgeon for Elon Musk's Neuralink, Dr. Matthew MacDougall
Tesla founder Elon Musk hired Matthew MacDougall, MD, a practicing neurosurgeon, to participate in a new project to develop a brain-computer interface technology and advance treatment for brain disorders, according to the Wall Street Journal.

Sanford Health to stop use of neurosurgeon's devices while federal investigation ongoing Sioux Falls, S.D.-based Sanford Health will halt the use of medical devices sold by a company owned by one of its neurosurgeons while a federal investigation into their use is ongoing, reports Argus Leader.

Cincinnati orthopedic group takes on PE investor, launches management services organization: 4 details
Cincinnati-based Beacon Orthopaedics and Sports Medicine launched a national management services organization in partnership with private equity firm Revelstoke Capital Partners.

Orthopedic practice partners with HOPCo to establish new Florida care network
Jacksonville, Fla.-based Southeast Orthopedic Specialists and Phoenix-based Healthcare Outcomes Performance Company partnered to form HOPCo Southeast Specialty Care Network.

Former Laser Spine Institute chairman of surgery lands at Colorado practice — 4 insights
Former Laser Spine Institute surgery chairman Michael Weiss, MD, PhD, joined Lone Tree, Colo.-based SpineOne.

US News: 20 best hospitals for neurology and neurosurgery
Best Hospitals for Neurology & Neurosurgery 2019-20 was published by U.S. News & World Report, with Johns Hopkins Hospital in Baltimore ranking No. 1.

OrthoVirginia sells medical office building housing practice to Montecito Medical — 3 insights
Lynchburg-based OrthoVirginia sold the 88,000-square-foot medical office building housing one of its practices to Montecito Medical Real Estate.

Oregon medical group to acquire 14-physician orthopedic practice — 3 things to know
Pendleton, Ore.-based Praxis Medical Group will acquire Desert Orthopedics of Bend, Ore., according to The Bulletin.

Andrews' Dr. David Chandler on the past 30 years of spinal innovation
David Chandler, MD, an orthopedic spine specialist at Gulf Breeze, Fla.-based Andrews Institute for Orthopaedics & Sports Medicine, reviewed the last 30 years of spine surgery innovation, offering insights into an array of advancing technologies in an interview for Andrews' Institute.

Orlin & Cohen Orthopedic Group acquires 10-physician orthopedic practice in New York: 4 notes
Merrick, N.Y.-based Orlin & Cohen Orthopedic Group acquired Long Island Bone & Joint.

Why Dr. Dominic Thomas Kleinhenz joined University Orthopedics and the biggest obstacle in spine
The Center for Spine Health at Providence, R.I.-based University Orthopedics added Dominic Thomas Kleinhenz, MD, to its medical staff.

GASTROENTEROLOGY

CMS’ proposed rate hikes for 10 most common GI procedures
The American College of Gastroenterology, the American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy outlined how reimbursement for the top 10 GI procedures in ASCcs will change under the CMS 2020 proposed rule.

'US News & World Report' names the top 10 hospitals for GI
U.S. News & World Report released its 2019 Best Hospital rankings July 30.

GI societies welcome parts of proposed payment changes
The American College of Gastroenterology, American Gastroenterological Association and American Society for Gastrointestinal Endoscopy outlined how the proposed changes to the 2020 Physician Fee Schedule and Outpatient Prospective Payment System will affect gastroenterologists.

Exact Sciences acquiring genomic-based diagnostic testing company in $2.8B deal — 5 insights
Exact Sciences will acquire diagnostic testing company Genomic Health in a $72 per share, $2.8 billion dollar deal, creating a globally focused cancer diagnostics company in the process.

GI Alliance invests in 5 ASCs
GI Alliance, an independent gastroenterology services organization, invested in five ASCs owned by Texas Digestive Disease Consultants and the Illinois Gastroenterology Group.

QUALITY

The 17 medical specialties that saw a pay increase or drop in 2019
Many medical specialties saw an increase in average pay this year, while a few saw a decrease, according to the Merritt Hawkins 2019 review of physician and advanced practitioner recruiting incentives.

The 3 most challenging ASC infection control areas
ASC technology developer Surgical Information Systems' chief nursing officer Ann Geier weighed in on the top infection control challenges for ASCs.

Top 10 highest paying physician specialties
Invasive cardiologists make the highest average yearly salary, according to the Merritt Hawkins 2019 review of physician and advanced practitioner recruiting incentives.

HEALTHCARE NEWS

10 best, worst states for healthcare in 2019, ranked by WalletHub
Americans in Minnesota receive the best healthcare in the country, while Alaskans receive the worst, according to a ranking from personal finance website WalletHub.

Struggling New York hospital secures buyer, $20M in funding
Massena (N.Y.) Memorial Hospital has been awarded a $20 million grant from New York State's Health Care Facility Transformation Fund.

WSJ: Trump administration working on alternative to 'Medicare for All'
The Trump administration is readying a healthcare plan as a rebuttal to Democrats' "Medicare for All" proposals and as a fallback in case the ACA is repealed, anonymous sources told The Wall Street Journal.

Wrong-site kidney surgery was a ‘mistake,’ say Vanderbilt physicians
Two physicians admitted they mistakenly placed a medical device in the wrong kidney during a 2017 procedure at Nashville, Tenn.-based Vanderbilt University Medical Center, an error for which they are being investigated by the state health department, according to The Tennessean.

HCA says it's open to rule on publishing hospital rates, welcomes competition
Nashville, Tenn.-based HCA Healthcare said it is receptive to a proposed hospital price transparency rule from CMS and the competitive opportunities it could bring, according to Nashville Public Radio.

CHS divests hospitals in Tennessee, Texas CHS divests hospitals in Tennessee, Texas Divests
Franklin, Tenn.-based Community Health Systems has completed the sale of College Station (Texas) Medical Center and Tennova Healthcare-Lebanon (Tenn.).

Why Democrats aren't blaming hospitals for healthcare costs
The early rounds of debates suggest Democrats have decided on one issue: Insurance companies — and to some degree pharmaceutical companies — are responsible for the United States' healthcare cost predicament, as Olga Khazan points out in a July 31 column in The Atlantic.

White House racing to craft healthcare measures ahead of election
White House advisers are meeting with President Donald Trump daily with an aim to unveil a new healthcare measure every two to three weeks until the 2020 election, according to The Washington Post.

HCA defeats false claims lawsuit over office deals
The 11th Circuit Court of Appeals refused to revive a False Claims Act lawsuit against HCA Healthcare, alleging the Nashville, Tenn.-based hospital operator illegally induced physician referrals.

Cigna may sell $6B group insurance unit
Cigna is considering selling its group benefits insurance arm, which may be valued as high as $6 billion, according to Reuters.

Patient data from EHR vendors found for sale online
Google Chrome and Mozilla Firefox browser extensions were used to extract and sell users' personal information from more than 50 companies, including EHR providers DrChrono and Kareo, according to the Washington Post.

Health insurance becoming unaffordable for employees, too
While employees often only pay a fraction of what their employers do for health insurance, out-of-pocket costs for workers are rising, according to CNBC.

Trump considers payroll tax cut — what it could mean for healthcare
The White House is considering a payroll tax cut, President Donald Trump confirmed Aug. 20, according to The Washington Post.

Care New England CEO accuses Lifespan of retaliation after merger talks collapse
The relationship between the CEOs of Care New England Health System and Lifespan has become increasingly tense since the Providence, R.I.-based organizations ended merger talks in July, according to The Boston Globe.