CMS Grants Quality Reporting Exemptions for ASCs Affected By Harvey and Irma

September 15, 2017

The Centers for Medicare & Medicaid Services (CMS) has announced it will grant exceptions for Medicare quality reporting requirements to ASCs in areas affected by Hurricanes Harvey and Irma, according to the Ambulatory Surgery Center Association (ASCA).

ASCs will receive exceptions without having to submit an extraordinary circumstances exception (ECE) request if they are located in counties, parishes, municipios or county-equivalents designated by the Federal Emergency Management Agency (FEMA) as a major disaster location.

As CMS memos on Harvey and Irma note, ASCs located in these areas will receive an exception for the following reporting requirements under the Ambulatory Surgical Center Quality Reporting Program:

  • Data collection and submission requirements that apply for the remainder of Calendar Year (CY) 2017 and the 2017/2018 Influenza Season that relate to CY 2019 payment determinations. These exemptions apply to all data submitted via the QualityNet Secure Portal and the National Healthcare Safety Network (NHSN) web-based measure collection tools that are due May 15, 2018, including claims-based measures calculated from submitted Quality Data Codes (QDCs). This exemption does not apply to claims-based measures that do not utilize QDCs for calculation purposes.

ASCs located outside of the designated areas may submit ECE requests based on individual circumstances.

Read ASCA’s announcements, which provide additional information and identify FEMA-designated areas, on Harvey here and Irma here.

Ambulatory Surgery Centers Celebrate National ASC Week

August 7, 2017

Ambulatory surgery centers (ASCs) nationwide are celebrating National ASC Week, which begins today, August 7 and runs through August 11.

Over the past decade, numerous ASCs have hosted events — “ASC Days” — designed to educate the community and key policy and decision makers about the high-quality, low-cost surgical services provided in surgery centers.

Events include inviting elected officials for tours and hosting open houses to provide information to healthcare consumers.

The Outpatient Healthcare Strategies team hopes its partner ASCs, and all surgery centers, have a great National ASC Week. Thank you for what you do for millions of patients every year!

For more information about National ASC Week, click here.

CMS Issues 2018 ASC Payment Proposed Rule: 5 Things for ASCs to Know About

July 20, 2017

The Centers for Medicare & Medicaid Services recently issued its 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment System proposed rule.

It includes several proposed updates that should be interest to ASCs, including changes to quality provisions and payment rates.

Here are five of the key takeaways for ASCs to know.

1. OAS CAHPS implementation delay. CMS is proposing to delay the mandatory implementation of the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS) under the Ambulatory Surgical Center Quality Reporting (ASCQR) Program for 2018 data collection (connected to 2020 payment determination).

ASCs that would like to continue to administer the survey under the voluntary national implementation would be permitted to do so in 2018.

2. Payment increase of 1.9%. CMS is proposing to provide ASCs an effective payment update of 1.9% on average for all covered procedures. Actual updates may vary by code and specialty.

3. Significant changes to ASCQR Program. The ASCQR Program is the pay-for-reporting program that requires ASCs to meet requirements or receive a reduction of 2.0 percentage points in their annual payment update.

CMS is proposing to add three measures to the ASCQR program measure set for the 2021 and 2022 payment determinations and subsequent years. The three proposed measures are as follows:

  • ASC-16: Toxic Anterior Segment Syndrome (TASS) measure. This is based on aggregate measure data collected by the ASC via chart abstraction and assesses the number of ophthalmic anterior segment surgery patients diagnosed with TASS within two days of surgery (beginning with the 2021 payment determination).
  • ASC-17: Hospital Visits after Orthopedic Ambulatory Surgical Center Procedures. This assesses all-cause, unplanned hospital visits within seven days of an orthopedic procedure performed at an ASC (beginning with the 2022 payment determination).
  • ASC-18: Hospital Visits after Urology Ambulatory Surgical Center Procedures. This assesses all-cause, unplanned hospital visits occurring within seven days of the urology procedure performed at an ASC (beginning with the 2022 payment determination).

CMS is proposing to remove three measures for the 2019 payment determination and subsequent years. The three measures proposed for removal are as follows:

  • ASC-5: Prophylactic Intravenous (IV) Antibiotic Timing
  • ASC-6: Safe Surgery Checklist Use
  • ASC-7: ASC Facility Volume Data on Selected Procedures

4. Total knee arthroplasty removed from IPO. CMS is proposing to remove total knee arthroplasty from the Medicare inpatient-only (IPO) list. This list identifies procedures that are only paid under the Hospital Inpatient Prospective Payment System.

CMS is also seeking comment regarding whether partial and total hip arthroplasty should be removed the IPO list.

5. Comments on payment reform. ASC payment rates are tied to data derived from the OPPS. CMS noted that given concerns about the difference between OPPS payments relative to ASC payments (56% in 2017), CMS is soliciting comments on ways to improve payment accuracy to ASCs and on the collection of ASC cost data.

CMS will accept comments on the proposed rule until Sept. 11, 2017. It will respond to comments in a final rule on or about Nov. 1, 2017.

CDC Updates Surgical Site Infection Guideline

June 20, 2017

The Centers for Disease Control and Prevention (CDC) has updated its “Guideline for the Prevention of Surgical Site Infection.”

Published in the JAMA Surgery journal, the 2017 SSI guideline updates the last version, which was published in 1999.

CDC conducted a “targeted systematic review” of nearly 5,500 studies published from 1998 through April 2014. Findings include the following:

  • Prior to surgery, patients should shower or bathe with soap or an antiseptic agent on at least the night before the operative day.
  • Antimicrobial prophylaxis should be administered only when indicated (based on published clinical practice guidelines) and timed so that a bactericidal concentration of the agents is established in the serum and tissues when the incision is made.
  • Skin prep in the operating room should be performed using an alcohol-based agent, unless contraindicated.
  • For clean and clean-contaminated procedures, additional prophylactic antimicrobial agent doses should not be administered after the surgical incision is closed in the operating room, even in the presence of a drain.
  • Topical antimicrobial agents should not be applied to the surgical incision.
  • During surgery, glycemic control should be implemented using blood glucose target levels less than 200 mg/dL.
  • Normothermia should be maintained in all patients.
  • Increased fraction of inspired oxygen should be administered during surgery and after extubation in the immediate postoperative period for patients with normal pulmonary function undergoing general anesthesia with endotracheal intubation.

As CDC notes, recommendations made in the guideline should be incorporated into surgical quality improvement programs.

To review all of the findings and in greater detail, view the new SSI guideline.

Consumer Reports Provides Guidance on Selecting an ASC

June 12, 2017

Consumer Reports recently published a detailed reported on surgery centers covering a wide range of topics, including the advantages of outpatient surgery and how to select the right ASC for a procedure.

The column is titled “Get the Best Care at an Ambulatory Surgery Center.” Here are some of its key takeaways:

1. ASCs are expanding their scope of services. They are increasingly taking on more complex procedures, such as total joint replacement and spine surgery, while capturing more volume of complicated procedures such as hysterectomies.

2. Outpatient surgery offers numerous advantages. These include shorter stays, typically lower costs for patients, and lower rates of complications such as urinary tract infections and blood clots.

3. ASCs are great settings for many people. But not all. Consumers in good health are the strongest candidates for surgery in an ASC. If consumers are older and/or have health conditions and comorbidities (e.g., obesity, hypertension, history of heart attack or stroke), they are likely at increased risk of complications. In such cases, it is advisable for consumers to speak with their doctor to help determine the most appropriate setting.

4. Research is wise. Before consumers settle on a location for their outpatient surgical procedure, they should perform due diligence on the site and procedure. Consumer Reports recommends researching the following:

– Complication rates associated with the procedure and performing surgeon
– Certification from the Centers for Medicare & Medicaid Services (CMS)
– Surgeon experience performing the procedure
– Type of anesthesia and monitoring process
– Emergency and transfer plan

5. Prepare for recovery. To help reduce the risk of complications following their procedure, consumers should leave the facility only when feeling well, make sure to receive written discharge instructions, pre-arrange home support, and share any medical concerns during the follow-up call.

Access the Consumer Reports column here.

Outpatient Healthcare Strategies to Attend ASCA 2017

April 27, 2017

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Representatives of Outpatient Healthcare Strategies (OHS) will be attending ASCA 2017, the annual meeting of the Ambulatory Surgery Center Association (ASCA).

ASCA 2017 takes place May 3–6 in Washington, D.C. The meeting brings together thousands of representatives from ambulatory surgery centers (ASCs), industry experts, and product and service providers for several days of education and networking.

To arrange an on-site meeting with a representative of OHS, email info@outpatienthcs.com or contact us.

ASCA is the national membership association that represents ASCs and provides advocacy and resources to assist ASCs in delivering high quality, cost-effective ambulatory surgery to all the patients they serve.

Surgery Center Consultant Jessica Nantz Discusses Payer Contracting in Becker’s

December 5, 2016

Outpatient Healthcare Strategies President and Founder Jessica Nantz discusses payer contracting in a new column to Becker’s ASC Review.

The article is titled “6 ASC payer contracting missteps to avoid.”

In the piece, Ms. Nantz notes that payer contracting is not an easy or quick process, and ASCs often settle for less-than-satisfactory contracts. She  identifies six common mistakes ASC administrators make when negotiating with payers.

To access the article, click here.

Ambulatory Surgery Center Consultant Arthur E. Casey Discusses Recruitment of Physician Investors

August 16, 2016

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Arthur E. Casey, senior vice president of Outpatient Healthcare Strategies, is featured in a new Becker’s ASC Review column.

The article is titled “Finding the perfect fit: 3 areas of focus when recruiting physician investors.”

In the piece, Mr. Casey discusses the importance of ambulatory surgery centers bringing in new investors, specifically those that are a good fit for the ASC in terms of personality, cost-effectiveness and the desire to be a business owner.

To read the article, click here.

ASC Consultant Jessica Nantz Discusses Hybrid ASC Model in Becker’s ASC Review

June 14, 2016

Outpatient Healthcare Strategies President and Founder of Outpatient Healthcare Strategies Jessica Nantz has contributed a new column to Becker’s ASC Review.

The article is titled “Hybrid ASC self-management model: 8 benefits to know.”

In the piece, Ms. Nantz discusses the “hybrid self-management model,” in which an ASC contracts with an individual(s) or company with knowledge in ASC clinical and/or financial management operations. She then identifies and explains eight benefits of the model.

To access the article, click here.

Surgery Center Consultant Jessica Nantz Writes About the Alternative Hybrid ASC Management Model

December 14, 2015

Ambulatory surgery center consultant and President and Founder of Outpatient Healthcare Strategies Jessica Nantz has contributed a new column to Becker’s ASC Review.

The article is titled “The alternative ambulatory surgery center management model: 6 things to know.” Ms. Nantz begins the piece by discussing the merits of the most common functional management models for ASCs before identifying a frequently overlooked model ASCs should be considering: the hybrid of the independent self-management model. In this model, the ASC contracts with an individual(s) or company with extensive knowledge in ASC financial management and clinical operations. Ms. Nantz explains six reasons for ASCs to consider this model.

To access the article, click here.

ASC Consulting Firm Outpatient Healthcare Strategies Named Company to Watch in 2016

December 1, 2015

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Outpatient Healthcare Strategies has once again been named an ambulatory surgery center (ASC) management and development company to watch by Becker’s ASC Review.

The profile for the company reads as follows:

Outpatient Healthcare Strategies provides operational, financial, clinical and business strategies for ASCs, physicians and hospitals. The company helps with payer contracting, benchmarking, clinical assessments and joint ventures, among other services. Founder of Outpatient Healthcare Strategies, Jessica Nantz serves as president and CEO. Equipped with 15 years of experience in the outpatient healthcare industry, Ms. Nantz has operated and managed more than 80 facilities, including ASCs.

To view the list of ASC management and development company to watch in 2016, click here.

ASC Consultant Jessica Nantz Discusses Merchant Service Providers in Becker’s ASC Review

October 20, 2015

Outpatient Healthcare Strategies President and Founder Jessica Nantz has contributed a new column to Becker’s ASC Review.

The article is titled “Switching merchant service providers: 5 key considerations.” Ms. Nantz previously contributed a column that discussed four questions ASCs should ask themselves when considering whether there is an opportunity to reduce merchant services costs. In the new column, Ms. Nantz notes that whether an ASC is setting up merchant services for the first time or researching alternatives to an existing vendor, this is a significant decision. She identifies five key considerations when choosing or switching market service providers.

Ms. Nantz includes the insight of Peter Kipp, PhD, president of Merchant Services Fee Advisors, a merchant services consulting firm, in the column.

To access the article, click here.

Outpatient Services Consultant Jessica Nantz Discusses Merchant Services in Becker’s Hospital Review Column

July 28, 2015

Jessica Nantz, president and founder of outpatient services consulting firm Outpatient Healthcare Strategies, has contributed a new column to Becker’s Hospital Review.

The column is titled “Saving on merchant services: 5 questions for hospitals to ask themselves.” In the piece, Ms. Nantz notes that payment processing costs is often an overlooked area hospitals can target for cost reduction opportunities. She outlines a series of questions for hospitals to address to help determine savings opportunities surrounding merchant services.

In the column, Ms. Nantz includes the insight of Peter Kipp, PhD, president of Merchant Services Fee Advisors, a merchant services consulting firm.

To access the article, click here.

Surgery Center Consultant Jessica Nantz Discusses Merchant Services in Becker’s ASC Review Column

May 18, 2015

Jessica Nantz, president and founder of surgery center consulting firm Outpatient Healthcare Strategies, has contributed a new column to Becker’s ASC Review.

The article is titled “Saving on merchant services: 4 questions for ASCs to ask themselves.” In the column, Ms. Nantz notes that cost reduction opportunities associated with almost every element of an ASC’s operation have been identified and discussed, but one area that has been largely overlooked is payment processing costs. She discusses the role of a merchant services provider in the processing and the opportunities that may exist for reducing merchant services costs.

Ms. Nantz includes the insight of Peter Kipp, PhD, president of Merchant Services Fee Advisors, a merchant services consulting firm, in the column.

To access the article, click here.

ASC Consultant Jessica Nantz of Outpatient Healthcare Strategies Named Woman Leader to Know

April 28, 2015

Jessica Nantz, President and Founder of Outpatient Healthcare Strategies, has once again been named one of the women leaders in the ambulatory surgery center (ASC) industry to know in 2015 by Becker’s ASC Review.

Ms. Nantz’s profile in the report reads as follows:

Jessica Nantz is the founder, president and CEO of Outpatient Healthcare Strategies. Ms. Nantz has more than 25 years of experience in healthcare and more than 15 years of experience in the outpatient setting. Prior to Outpatient Healthcare Strategies, she founded ASC coding company mdStrategies and ASC Strategies. Ms. Nantz has expertise in ASC and hospital outpatient department operational efficiencies.

To view the complete list of women leaders in the ASC industry to know, click here.

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