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Ep. 14: Kara Newbury – Acting on CMS’ 2023 Final Medicare Rule |This Week in Surgery Centers
Here’s what to expect on this week’s episode. 🎙️
Since the 2023 Final Rule was published this past November, ASCs have rightfully had a lot of questions trying to decipher what Centers for Medicare & Medicaid Services requires this year.
Kara Newbury, the Ambulatory Surgery Center Association’s Director of Government Affairs and Regulatory Counsel, has advocated for ASCs for over ten years, and she’s here with us today to help us decipher the changes as we’re officially in the new year. Here are a few highlights.
💰 Medicare Reimbursement Rate – The effective update is 3.8%. While it’s disappointing it wasn’t higher, as we know ASCs are facing so many increased costs right now, it’s a small win that it was higher than the original 2.7% in the proposed rule.
📝 ASC Covered Procedures List – Every year, ASCA surveys its members to see what procedures they perform in the private pay market that would be safe for Medicare patients. Out of the dozens ASCA submitted, #CMS only added four new procedures in 2023.
✋ Nomination Process – CMS is introducing a new nomination process so that any ASC stakeholder can submit codes that they believe should be payable in the #Medicare space. This process will start on January 1, 2024, which means it will be effective for 2025 rulemaking.
✍️ Complexity Adjustment Policy – This is a huge win for ASCs. Fifty-five code combinations were approved for ASCs, which will increase reimbursement for cases that end up being more complex and have a higher cost.
📊 ASC Quality Reporting Program – While there were a handful of reporting changes, it’s important to know that data for ASC measures 1-4 (burns, falls, wrong events, and hospital transfers) must be collected for all patients and is no longer claims-based. ASCs will then submit data through a web-based portal starting in May.
Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details!
Episode Transcript
0:00
welcome to this week in surgery centers
0:03
if you’re in the ASC industry then
0:05
you’re in the right place every week
0:07
we’ll start the episode off by sharing
0:10
an interesting conversation we had with
0:11
our featured guests and then we’ll close
0:13
the episode by recapping the latest news
0:15
impacting surgery centers we’re excited
0:18
to share with you what we have so let’s
0:20
get started and see what the industry’s
0:22
been up to
0:23
[Music]
0:27
hi everyone here’s what you can expect
0:29
on today’s episode
0:31
this week’s guest needs no introduction
0:34
Kara Newberry aska’s director of
0:37
government Affairs and Regulatory
0:39
council is here today to share what ASCS
0:42
need to do to start acting on cms’s 2023
0:46
final Medicare rule Carol walks us
0:49
through reimbursement rates the covered
0:51
procedures list the complexity
0:53
adjustment policy and more
0:55
in our news recap we’ll cover five
0:57
Trends ASCS need to know in 2023 how a
1:01
hospital recovered thirty five thousand
1:03
dollars worth of lost instrument and
1:05
nine months tips for adopting new tech
1:08
in 2023 and of course and the new
1:11
segment with a positive story about a
1:13
doctor who saved two lives during a half
1:15
marathon
1:16
hope everyone enjoys the episode and
1:19
here’s what’s going on this week in
1:21
surgery centers
1:23
[Music]
1:25
yeah welcome to the show
1:28
thanks thanks for having me
1:30
appreciate you joining us today and I
1:33
know that many of our listeners are
1:35
going to be familiar with you and your
1:36
name given the work that you do in this
1:39
industry and advocating for this
1:40
industry but for those that may not know
1:43
you can you give us a little bit of an
1:45
overview on on yourself and and the work
1:48
that you do
1:49
sure absolutely
1:51
um so Kara Newberry I work for the
1:53
Ambulatory Surgery Center Association
1:55
I’ve been with ASCA for uh more than 11
1:58
years now and my current role is
2:01
regulatory Council and director of
2:03
government Affairs so I’m basically
2:06
spearheading all of the advocacy work
2:08
that ASCA does
2:12
fantastic and we’re excited to have you
2:14
on in general but super excited with
2:16
this timing with CMS publishing their
2:20
final rule in just a couple weeks ago I
2:21
believe and wanted wanted to ask you a
2:24
couple questions about that you know
2:26
there’s there’s folks that we talk to
2:27
trying to interpret and understand
2:28
different pieces and so if it’s okay I
2:31
wanted to ask you a couple kind of
2:32
clarifying questions as it relates to
2:35
the ruler
2:37
uh so to start can you give our
2:39
listeners a quick overview of the
2:41
increases to Medicare reimbursement
2:43
rates for for 23.
2:46
sure
2:47
um so I’ll just start out by saying you
2:49
know because usually I’m uh called a
2:51
Debbie Downer when I give some of these
2:54
updates so
2:55
um you know it it was slightly more
2:58
positive than was in the proposed role
3:01
so I have to start out I guess with a
3:02
little bit of a positive so the
3:04
effective update for ASCS is 3.8 percent
3:10
um you know obviously 3.8 percent is
3:13
nowhere near what we know our facilities
3:15
are facing in terms of increased costs
3:18
um Staffing costs supplies you know
3:21
overheads so you know we were
3:24
disappointed that it wasn’t higher but
3:26
it was like I said at least a little
3:28
better than the 2.7 percent effective
3:31
update that had been in the proposed
3:33
role
3:34
got it and can you tell us a little bit
3:37
about the changes to the ASC covered
3:40
procedure list
3:42
sure so every year
3:46
um primarily led by their medical
3:47
officers is looking at and evaluating
3:50
procedures that may be eligible for
3:54
addition to the ASE cover procedure list
3:57
for the coming year
4:00
um and unfortunately you know once again
4:03
playing Debbie Downer well I guess but
4:05
um they had only proposed one procedure
4:07
to be added to the list
4:10
and aska had submitted I think 37 codes
4:15
for their consideration we had gone to
4:18
our members and done a survey to ask
4:21
what procedures our members were doing
4:23
on you know private Pay Market that they
4:27
thought would be safe for Medicare
4:29
beneficiaries and in the proposed role
4:32
they only added one in the final rule
4:35
they did increase that to four so there
4:38
were four procedures that were added to
4:41
the ASC cover procedure list for 2023
4:44
probably most most significant to the
4:48
listeners and at least our members would
4:50
be CPT code 19307 that’s a medical I’m
4:55
sorry that’s a radical mastectomy code
4:58
that we have been requesting for some
5:01
time now but all the procedures that we
5:04
had you know asked CMS for are done
5:08
primarily in the outpatient space so
5:11
although we were disappointed that there
5:13
were only four procedures added you know
5:15
we’re excited that in the future CMS is
5:18
going to start a new nomination process
5:21
where you know any interested
5:24
stakeholders so all the listeners for
5:28
this podcast hopefully you’ll submit
5:29
codes in the future that you think
5:32
should be payable in the Medicare space
5:35
unfortunately that process has been
5:37
delayed and so that won’t start until
5:40
January 1 2024 which would be effective
5:43
for 2025 rule making so we have a little
5:47
bit of time before that and goes into
5:48
place so ASCA is planning on being very
5:52
proactive in 2023 we’re scheduling a
5:56
meeting to go speak with Medicare
5:59
medical officers in January or early
6:02
February to present codes that we would
6:05
like to see added one of the primary
6:07
codes that we’re pushing hard for in
6:10
future rulemaking so it wouldn’t be 2024
6:12
at the earliest but one of the codes
6:14
we’re pushing for is total shoulder
6:16
arthroplasty it’s far and away the
6:19
procedure lately that’s been getting the
6:21
most traction and you know had the most
6:23
requests from our members so you know
6:26
more to come on that but I will just put
6:29
in a quick plug to anyone listening if
6:31
you have any outcomes data
6:35
from your facility specifically on total
6:38
shoulder we would welcome that
6:40
information
6:41
CMS is very interested in you know
6:45
seeing actual data and like I said you
6:48
know how the procedures how many
6:51
procedures are being performed we can
6:52
typically pull that kind of information
6:53
we have access to volume data but they
6:56
are looking at outcomes data you know so
7:00
they can show that they’ll be safe
7:02
procedures to be performed in ASC so any
7:05
help we can get we would welcome that
7:09
very helpful and and just you know it’s
7:12
a couple follow-up questions there for
7:14
from a context perspective you said
7:16
there’s four procedures in the final
7:18
rule how does that compare to previous
7:20
years
7:21
so it’s fairly consistent unfortunately
7:24
and that’s part of the reason that we
7:27
wanted this new more formal nomination
7:29
process where you can eventually go on
7:31
the CMS website submit codes through a
7:34
portal and then CMS will have to respond
7:36
to those codes because in the past you
7:39
know we’ve you know gone and presented
7:41
to CMS and it’s kind of like
7:44
you know you don’t hear back and then
7:47
and then it’s either in the proposed
7:49
rule or it’s not
7:51
um and anywhere from zero procedures
7:54
added to we did have you know a couple
7:56
years where we got like 17 codes those
7:59
were typically in years where we had
8:01
like certain Specialties that were
8:02
focused on so
8:04
um you know you may remember that a few
8:06
years ago we had some cardiovascular
8:08
codes added to our list so we got 17
8:11
codes I think
8:13
um at that time
8:15
um but they were all within the same you
8:17
know specialty but it’s typically you
8:19
know between I’d say four to six codes a
8:22
year so slow movement
8:25
um unfortunately but we are like I said
8:29
being more pro at planning on being more
8:31
proactive in 2023 we kind of took a
8:34
little bit of a Hiatus
8:36
um taking surgeons to meet with CMS
8:39
medical officers during the pandemic but
8:42
we are picking that up and resuming that
8:45
in 2023
8:48
so so slow but steady progress
8:51
um and it sounds like hey at least
8:53
there’s line of sight into a new more
8:56
structured hopefully more visibility uh
9:00
nomination process
9:02
until then you mentioned that ask is is
9:04
continuing to help us fill that Gap
9:07
um how does aska go about determining
9:10
what you guys put on your recommendation
9:12
list from a CPT code perspective
9:14
absolutely so we do a survey of our
9:20
members every year and we ask for them
9:23
to submit codes to us that they would
9:26
like to be considered and then we always
9:29
ask for all of those procedures we also
9:33
go to look at the claims data that we
9:37
have access to for private payer claims
9:41
and we look to see how often those codes
9:45
are being done in the outpatient setting
9:47
both ASCS and Hospital outpatient
9:50
Apartments I would argue hopefully most
9:52
in our space would argue that in terms
9:55
of safety and quality ases and Hospital
9:58
outpatient apartments are pretty much
10:00
one in the same so you know we argue
10:03
consistently to CMS that anything that
10:06
is allowed to be performed in a hospital
10:08
outpatient apartment should also be
10:10
allowed on the ASC cover procedure list
10:13
but it’s all based on member
10:16
recommendations and then in addition to
10:18
that we will include other procedures
10:22
that we see that are being done in high
10:24
volume in case you know we just didn’t
10:26
hear from those folks those doctors who
10:29
are performing you know other procedures
10:32
so it’s usually high volume and anything
10:35
that is requested from membership
10:38
great
10:40
um and another piece I want to touch on
10:41
that that you mentioned was the outcomes
10:45
data that that seems to be pretty
10:47
important
10:48
um in in the CMS decisioning what what
10:52
type of outcome data or outcome tracking
10:54
have you seemed to be most effective
10:56
because this this outcome term can mean
10:59
different things I mean different folks
11:00
and and it can be hard in terms of hey
11:03
what really is going to hold up under
11:05
the scrutiny it’s tough too because I
11:07
think sometimes CMS doesn’t even know
11:09
what it’s looking for
11:11
um we you know provided them with a
11:14
couple of research studies in the past
11:16
two years of rulemaking uh specific to
11:19
total shoulder total ankle and a spine
11:22
fusion code and it was successful two
11:26
years ago keeping those codes off of
11:28
going back on the inpatient only list
11:30
some listeners may remember that there
11:32
were huge sweeping changes made during
11:34
the final year of the Trump
11:35
Administration and then the Biden
11:37
Administration in its first year kind of
11:40
pulled back a lot on those changes and
11:43
so they were planning on adding like
11:45
total shoulder total ankle and some
11:48
spine codes back to the inpatient only
11:50
list we are success possible keeping
11:51
those off and thought that you know the
11:54
research that we shared was probably
11:55
compelling and helpful with that but
11:57
then when we shared similar research and
12:00
information you know this year or last
12:03
year for
12:04
2023 rule making you know it wasn’t as
12:07
compelling
12:09
um part of the reason that we need to go
12:10
meet with CMS is because
12:13
we want further guidance in terms of
12:16
what is going to move the needle in the
12:20
final rule they said that the data
12:22
wasn’t compelling because I guess it
12:24
wasn’t enough volume to look at and then
12:27
they also made this weird argument about
12:29
you know is it transferable across all
12:32
surgery centers and I didn’t exactly
12:34
understand what that meant like you know
12:36
an eye center is not going to all of a
12:38
sudden start doing total shoulder
12:39
surgery but anybody who’s already doing
12:42
total joint Replacements you know I have
12:44
full confidence in our facilities that
12:46
those who are doing total joint
12:48
Replacements are safe and effective and
12:50
could add to total shoulder Medicare
12:52
volume to that mix so like I said it’s
12:55
kind of unclear what exactly they want
12:57
and of course you know the outcomes data
13:00
for each type of procedure varies
13:03
um you know so for a lot of these joint
13:06
Replacements they’re looking to see
13:09
um you know infections they’re looking
13:11
to see
13:13
um you know was there a follow depending
13:15
on the surgery was there a follow-up
13:16
required
13:18
um so you know really any data that that
13:22
we get our hands on we share with CMS
13:25
because anything is better than better
13:27
than nothing and like I said it’s still
13:29
kind of unclear to US based on the
13:31
responses that we’ve gotten from them in
13:33
previous meetings what exactly they’re
13:35
looking for
13:36
sure okay well shifting gears on you a
13:40
little bit uh maybe more of a kind of
13:42
positive glass is half full perspective
13:44
the ruling for my understanding does
13:46
include some complexity adjustments
13:49
um for certain code code combinations I
13:51
believe can you explain what the policy
13:53
does
13:55
um you know and talk about the benefit
13:56
of that for the industry sure absolutely
13:59
so this was a big win for ASCS and a
14:03
good starting point for this policy so
14:06
for Hospital outpatient apartments for
14:07
some time they’ve had this complexity
14:10
adjustment so CMS takes the you know
14:14
primary surgical code that’s being done
14:16
and then an add-on code that’s done in
14:19
conjunction with that and they bump up
14:21
you know the reimbursement rate because
14:24
they’re saying that the add-on code
14:26
changes the complexity and the cost of
14:30
Performing that procedure so typically
14:33
um for every you know run-of-the-mill
14:35
case add-on codes are not separately
14:38
payable they’re they’re N1 payment
14:40
indicator and there’s no additional
14:42
reimbursement available but CMS has
14:46
found like I said these code
14:47
combinations for 2023 there are 55 of
14:50
them in the ASC setting for which the
14:54
add-on is going to you know increase
14:57
that reimbursement for ases so
15:00
um you know it’s it’s a start there are
15:02
certainly other code combinations we’re
15:04
looking to get added there’s not really
15:06
a ton of spine on there and we know for
15:08
a fact that there are a lot of spying
15:10
code combinations with an add-on that
15:13
you know certainly are more complex and
15:15
costlier so one example I’ve been giving
15:18
is removal of thyroid so the primary
15:20
code is
15:22
60240 and there’s often an add-on with
15:26
that
15:27
60512 that would typically not be
15:31
reimbursed under under the 2022 and you
15:34
know prior Medicare policies
15:37
um but CMS has found that when those
15:39
codes are done in combination it’s
15:41
costlier more complex and so now this
15:44
new C code that CMS has established is
15:48
c7555 and it has a reimbursement rate of
15:51
around 4 200. so basically an increase
15:54
of you know 17 1800 because of you know
15:59
those codes being done in combination so
16:02
ask is going to put out more resources
16:05
we also have some already available on
16:07
our website so you can see which code
16:09
combinations are already
16:12
um you know going to get this new
16:14
complexity adjustment but as I said
16:17
we’re really going to be pushing for a
16:19
lot more code combinations in the future
16:21
specifically in the spine area
16:25
great sounds like some something we can
16:27
build on yeah uh can you tell me a
16:30
little bit about Quality Reporting and I
16:32
understand there’s a linkage between
16:33
medicare’s Quality Reporting and and
16:37
payments and and can you tell me a
16:38
little bit about how that how that
16:40
linkage works and what the implications
16:41
are sure
16:43
um so I don’t know if everybody
16:45
um who’s listening realizes this but
16:47
updates to our Quality Reporting program
16:49
are always found in our payment rule
16:52
because there could be a two percent
16:54
penalty if you fail to uh report under
16:58
the ASE Quality Reporting program so
17:01
um in this year’s final rule there
17:03
weren’t a ton of significant changes
17:06
um you know we did
17:08
um kind of push back ASC 11 which is
17:11
this cataract Improvement in patients
17:14
visual function within 90 days measure
17:16
it’s one that we’ve been
17:18
um
17:19
push advocating against I guess you
17:21
would say for almost a decade now
17:24
because it’s really a physician measure
17:26
it’s not a facility level measure
17:29
um and so we’ll continue to push back on
17:31
that but I did just want to let everyone
17:33
know as a reminder that we have a few
17:37
outcomes measures that are back in our
17:39
Quality Reporting program as of uh 2023
17:43
data collection so ASE one through four
17:46
they were you know the first measures
17:48
that were added to our program back in
17:51
2012 when it was first initiated so
17:55
Burns Falls wrong events and Hospital
17:58
transfers just a reminder that you have
18:01
to collect data for those again and I
18:04
know we’ve been getting a lot of
18:05
questions that ask us so you know you
18:07
might get a lot of questions too it is
18:10
not claims based anymore so you used to
18:12
submit those on your fee for service
18:14
Medicare claims that’s no longer the
18:16
case now you’re collecting that data for
18:19
all of your patients and then you’ll be
18:21
submitting it through the web-based
18:23
portal that CMS has next May so just you
18:27
know wanted to remind everyone on that I
18:29
know we’ve been getting a lot of
18:30
questions so I’m guessing that um you
18:33
might be getting some questions as well
18:37
absolutely fantastic
18:40
um anything else from a final ruling
18:42
perspective from a kind of macro topic
18:45
perspective that our listeners should be
18:46
aware of or keep an eye on
18:49
I think it’s just always important to
18:50
know that you know we are a small Cog in
18:54
you know this larger machine and you
18:59
know really there’s a lot of discussions
19:00
and Rumblings happening right now about
19:02
a complete overhaul and more significant
19:05
changes to the Medicare program I’ve
19:07
talked with a lot of folks at CMS about
19:09
this and I would love to be part of
19:11
those discussions because I think that
19:12
there are definitely improvements that
19:15
could be made
19:16
um but you know I was just listening to
19:18
the medpack meeting a few weeks ago and
19:22
I think that they said that we are 0.5
19:24
of the Medicare spend ases are so you
19:29
know although we think you know
19:31
obviously they’re you know 6100 CMS
19:34
certified ASCS and we’re saving Medicare
19:37
you know billions of dollars a year but
19:39
we’re still a very small piece of the
19:41
puzzle but I think that we you know do a
19:44
good job at ASCA even even though we’re
19:46
a small piece of the Medicare puzzle you
19:48
know kind of hitting above our weight or
19:52
you know getting a lot of
19:54
um you know positives for our industry
19:56
so
19:58
um
19:58
go love it and appreciate appreciate all
20:00
that you do and Alaska does on on behalf
20:03
of the industry
20:05
um Kira final question for you and we
20:09
asked this for for all of our guests
20:10
every week
20:12
what’s one thing our listeners can do
20:14
this week over the near term to improve
20:16
their surgery centers
20:18
okay it’s a little self-serving
20:21
um but ASCA is uh hosting our first
20:24
fly-in in three years
20:26
um and I would say you know if at all
20:30
possible if you can come and participate
20:32
in our you know fly-in also known as our
20:34
national advocacy day you know really
20:36
that’s how you’re going to help make an
20:39
impact not only for your facility but
20:40
the industry as a whole is getting in
20:43
front of your elected officials and you
20:45
know telling them your story and how
20:47
great you are that’s how we really get
20:49
through to them if that’s not feasible I
20:52
would say you know host a facility tour
20:54
and bring folks in you know I would I’m
20:57
not a clinical person and I could never
20:59
give advice on you know how to run your
21:01
surgery center I’m also not you know
21:02
business person in that sense but
21:04
um you know what we do here from elected
21:06
officials who you know go to bat for us
21:09
in Congress or in your States is that
21:13
really hearing your story what you’re
21:15
doing and all the great care you’re
21:16
providing is you know really what
21:19
resonates with them and gets them to
21:20
either sign on to our legislation or
21:22
help you know push different wins for
21:25
the industry so that’s that’s my plug I
21:27
you know I’d love for you all to bring
21:29
people into your facilities or come to
21:30
DC if you have the ability and for folks
21:33
that are interested in learning more
21:34
about the flying day and what that
21:36
entails uh where can they get some
21:38
information on that sure you can reach
21:41
out to me you can go to our website
21:45
ascassociation.org
21:47
and you can like like I said feel free
21:50
to reach out to me follow us on all the
21:52
social media platforms we have more
21:54
information there as well
21:56
fantastic Garrett thanks so much for
21:58
joining us today yep thank you
22:02
[Music]
22:05
as always it has been a busy week in
22:07
healthcare so let’s jump right in our
22:10
first story of the New Year comes from
22:11
Becker’s ASC review with the end of the
22:14
year comes a bunch of Articles recapping
22:16
2022 and looking ahead to the new year
22:19
and this article is the latter Becker
22:22
has published a write-up titled five
22:24
Trends ASCS need to know in 2023 and
22:27
here’s the Scoop Trend number one is
22:30
value-based care with low-cost high
22:33
quality procedures ASCS are set up for
22:35
success as Healthcare transitions to
22:37
this payment model
22:39
ases have always offered high quality
22:41
results so this payment model will bode
22:43
well for the industry
22:45
and minutes from optum’s investor
22:47
meeting in October they share that their
22:49
revenue per consumer has grown 31 and
22:53
they attribute that success to the
22:55
increasing number of patients served
22:57
under value-based care relationships and
23:00
if you do look at their minutes and you
23:02
do a quick search for value-based care
23:04
you’ll see that that term comes up over
23:07
a dozen times which is very telling
23:10
Trend number two is physician pay cuts
23:13
medicare’s physician fee schedule final
23:15
rule will reduce the conversion factor
23:18
by
23:19
4.48 to which is down to 33 dollars and
23:24
six cents there have been concerns that
23:27
the cut will push Physicians away from
23:29
ases and to larger Health Systems will
23:31
also lead to declining availability of
23:34
Physician Services
23:36
Trend number three is Staff shortages
23:38
now this is not news to anybody this is
23:42
one of the largest concerns for ASC ASCS
23:44
right now we’ve we’ve talked about it a
23:46
couple times
23:47
um there’s unfortunately no secret
23:49
solution here as you can’t cut Corners
23:51
with higher and qualified staff and vmg
23:55
health shared that many ASCS will have
23:58
to spend a quarter or more of their net
24:00
operating revenue on employees alone as
24:02
we look to next year so focus on
24:05
satisfaction and retention and
24:07
recruitment as much as you can
24:10
Trend number four is physician ownership
24:12
if there are employed physicians at your
24:15
ASC that are not currently stakeholders
24:18
you might want to consider including
24:20
them this will incentivize all
24:22
Physicians who work with you to not only
24:24
strive for their own day-to-day
24:26
satisfaction and good pay but to also
24:28
strive for the longevity and success of
24:31
the ASC and obviously with more cases
24:33
comes more revenue and more stability
24:37
Trend number five last but not least is
24:39
stagnant reimbursement rates ases are
24:42
paid much lower rates than Hospital
24:44
outpatient departments for the same
24:46
exact procedures so you need to keep a
24:49
close eye on payer behavior and really
24:51
build one-on-one relationships with your
24:53
payers as much as you can
24:55
and there you have it those are the five
24:57
Trends from Becker’s to keep an eye on
24:59
as we are officially now in the new year
25:03
our next piece of news comes from
25:05
outpatient surgery magazine and I
25:07
personally think this story is really
25:09
cool
25:10
um an airport style security scanner at
25:13
the University of Iowa Hospitals and
25:15
Clinics is saving tens of thousands of
25:17
dollars worth of valuable instruments
25:19
from accidentally entering the waste
25:21
stream
25:22
after each surgery bags of trash are
25:25
removed from the or they are run through
25:28
Environmental Services placed on a
25:30
conveyor belt and scanned each bag is
25:33
numbered to identify the room and
25:35
surgery from which it came from and if
25:37
the scan detects an instrument a nurse
25:39
is called to identify it and process it
25:41
correctly through the Sterile Processing
25:43
Department
25:45
this idea alone has recovered thirty
25:48
five thousand dollars worth of lost
25:50
instruments in its first nine months so
25:53
as we’re constantly thinking about ways
25:55
to reduce waste and save money this idea
25:58
checks both of those boxes
26:00
now I’m not sure how much the conveyor
26:02
belt cost but I’d imagine with an
26:05
average savings of roughly thirty eight
26:07
hundred dollars per month it will pay
26:10
for itself pretty quickly if it hasn’t
26:12
already
26:15
our third story comes from Med City News
26:18
and they put together a piece on seven
26:20
rules hospitals should follow when
26:22
adopting new tech and five of those
26:24
rules really apply to ASCS as well
26:28
if your surgery center is considering
26:30
adopting new technology in 2023 whether
26:33
it’s patient texting or an EHR or a
26:35
patient estimating tool keeping these
26:38
rules in mind will help you
26:39
significantly in the implementation
26:41
process
26:43
so first planning should begin during
26:45
the sales process work with your vendor
26:48
to set clear expectations timelines
26:50
implementation plans any hidden costs
26:53
and everything else don’t hold back with
26:56
your questions and don’t hold back on
26:59
pushing your render for Clear answers
27:01
until you’re comfortable with them
27:04
tip number two clearly Define governance
27:07
structures
27:08
um so by this they mean just organize a
27:10
leadership team for the project and make
27:13
sure members of the team have clear
27:15
roles and responsibilities now that
27:18
might seem like a no-brainer but it
27:20
shouldn’t be something that’s just
27:21
assumed we want this written down
27:24
um and everyone needs to buy in
27:27
tip number three is always communicate
27:30
everyone involved should have a clear
27:31
understanding of who’s doing what at all
27:33
times and why they’re doing it and
27:36
create an actual communication plan and
27:38
provide regular updates
27:41
tip number four is to prioritize
27:43
stakeholder alignment leaders of both
27:46
your ASC and the vendor must be
27:49
transparent with each other Express
27:51
buy-in and commit to success without
27:53
that stakeholder alignment the whole
27:56
process could fall out of whack
27:59
and the last tip here training is a
28:02
necessary investment and I couldn’t
28:04
agree more this is a huge one we just
28:06
did an episode on nursing informatics
28:08
which kind of ties in exactly to what
28:12
this tip is saying without proper
28:14
training end users usually don’t feel
28:16
comfortable adopting a new technology or
28:18
won’t be satisfied with it so early on
28:21
in the tech adoption process you should
28:23
designate who is responsible for
28:25
creating and delivering training
28:27
materials and assign power users to each
28:30
department without those power users and
28:34
without proper training
28:36
the carrier receive it the care patients
28:39
are receiving could be impacted and
28:41
patient safety could be impacted so make
28:44
sure you invest in training
28:47
and to end our new segment on a positive
28:49
note Dr Steve lomay saved two lives
28:52
during a half marathon recently Dr lomae
28:56
was running the marathon himself when he
28:58
saw Gregory Gonzalez a fellow Runner
29:00
fall and hit his head he immediately
29:03
began CPR until an ambulance arrived
29:07
then at the Finish Line another fellow
29:10
Runner Michael heilman also fell in his
29:13
head and the same chain of events
29:15
occurred Dr Lemay began CPR until an
29:17
ambulance arrived
29:19
both men ultimately had blockages that
29:21
led to their cardiac arrest and they
29:24
received stents in their coronary
29:25
arteries and are perfectly fine and the
29:28
three men plan to run the half marathon
29:31
together in 2023.
29:34
and that news story officially wraps up
29:36
this week’s podcast thank you as always
29:39
for spending a few minutes of your week
29:41
with us make sure to subscribe or leave
29:43
a review on whichever platform you’re
29:45
listening from I hope you have a great
29:47
day and we’ll see you again next week
29:52
[Music]
29:55
why are you keeping me
welcome to this week in surgery centers
0:03
if you’re in the ASC industry then
0:05
you’re in the right place every week
0:07
we’ll start the episode off by sharing
0:10
an interesting conversation we had with
0:11
our featured guests and then we’ll close
0:13
the episode by recapping the latest news
0:15
impacting surgery centers we’re excited
0:18
to share with you what we have so let’s
0:20
get started and see what the industry’s
0:22
been up to
0:23
[Music]
0:27
hi everyone here’s what you can expect
0:29
on today’s episode
0:31
this week’s guest needs no introduction
0:34
Kara Newberry aska’s director of
0:37
government Affairs and Regulatory
0:39
council is here today to share what ASCS
0:42
need to do to start acting on cms’s 2023
0:46
final Medicare rule Carol walks us
0:49
through reimbursement rates the covered
0:51
procedures list the complexity
0:53
adjustment policy and more
0:55
in our news recap we’ll cover five
0:57
Trends ASCS need to know in 2023 how a
1:01
hospital recovered thirty five thousand
1:03
dollars worth of lost instrument and
1:05
nine months tips for adopting new tech
1:08
in 2023 and of course and the new
1:11
segment with a positive story about a
1:13
doctor who saved two lives during a half
1:15
marathon
1:16
hope everyone enjoys the episode and
1:19
here’s what’s going on this week in
1:21
surgery centers
1:23
[Music]
1:25
yeah welcome to the show
1:28
thanks thanks for having me
1:30
appreciate you joining us today and I
1:33
know that many of our listeners are
1:35
going to be familiar with you and your
1:36
name given the work that you do in this
1:39
industry and advocating for this
1:40
industry but for those that may not know
1:43
you can you give us a little bit of an
1:45
overview on on yourself and and the work
1:48
that you do
1:49
sure absolutely
1:51
um so Kara Newberry I work for the
1:53
Ambulatory Surgery Center Association
1:55
I’ve been with ASCA for uh more than 11
1:58
years now and my current role is
2:01
regulatory Council and director of
2:03
government Affairs so I’m basically
2:06
spearheading all of the advocacy work
2:08
that ASCA does
2:12
fantastic and we’re excited to have you
2:14
on in general but super excited with
2:16
this timing with CMS publishing their
2:20
final rule in just a couple weeks ago I
2:21
believe and wanted wanted to ask you a
2:24
couple questions about that you know
2:26
there’s there’s folks that we talk to
2:27
trying to interpret and understand
2:28
different pieces and so if it’s okay I
2:31
wanted to ask you a couple kind of
2:32
clarifying questions as it relates to
2:35
the ruler
2:37
uh so to start can you give our
2:39
listeners a quick overview of the
2:41
increases to Medicare reimbursement
2:43
rates for for 23.
2:46
sure
2:47
um so I’ll just start out by saying you
2:49
know because usually I’m uh called a
2:51
Debbie Downer when I give some of these
2:54
updates so
2:55
um you know it it was slightly more
2:58
positive than was in the proposed role
3:01
so I have to start out I guess with a
3:02
little bit of a positive so the
3:04
effective update for ASCS is 3.8 percent
3:10
um you know obviously 3.8 percent is
3:13
nowhere near what we know our facilities
3:15
are facing in terms of increased costs
3:18
um Staffing costs supplies you know
3:21
overheads so you know we were
3:24
disappointed that it wasn’t higher but
3:26
it was like I said at least a little
3:28
better than the 2.7 percent effective
3:31
update that had been in the proposed
3:33
role
3:34
got it and can you tell us a little bit
3:37
about the changes to the ASC covered
3:40
procedure list
3:42
sure so every year
3:46
um primarily led by their medical
3:47
officers is looking at and evaluating
3:50
procedures that may be eligible for
3:54
addition to the ASE cover procedure list
3:57
for the coming year
4:00
um and unfortunately you know once again
4:03
playing Debbie Downer well I guess but
4:05
um they had only proposed one procedure
4:07
to be added to the list
4:10
and aska had submitted I think 37 codes
4:15
for their consideration we had gone to
4:18
our members and done a survey to ask
4:21
what procedures our members were doing
4:23
on you know private Pay Market that they
4:27
thought would be safe for Medicare
4:29
beneficiaries and in the proposed role
4:32
they only added one in the final rule
4:35
they did increase that to four so there
4:38
were four procedures that were added to
4:41
the ASC cover procedure list for 2023
4:44
probably most most significant to the
4:48
listeners and at least our members would
4:50
be CPT code 19307 that’s a medical I’m
4:55
sorry that’s a radical mastectomy code
4:58
that we have been requesting for some
5:01
time now but all the procedures that we
5:04
had you know asked CMS for are done
5:08
primarily in the outpatient space so
5:11
although we were disappointed that there
5:13
were only four procedures added you know
5:15
we’re excited that in the future CMS is
5:18
going to start a new nomination process
5:21
where you know any interested
5:24
stakeholders so all the listeners for
5:28
this podcast hopefully you’ll submit
5:29
codes in the future that you think
5:32
should be payable in the Medicare space
5:35
unfortunately that process has been
5:37
delayed and so that won’t start until
5:40
January 1 2024 which would be effective
5:43
for 2025 rule making so we have a little
5:47
bit of time before that and goes into
5:48
place so ASCA is planning on being very
5:52
proactive in 2023 we’re scheduling a
5:56
meeting to go speak with Medicare
5:59
medical officers in January or early
6:02
February to present codes that we would
6:05
like to see added one of the primary
6:07
codes that we’re pushing hard for in
6:10
future rulemaking so it wouldn’t be 2024
6:12
at the earliest but one of the codes
6:14
we’re pushing for is total shoulder
6:16
arthroplasty it’s far and away the
6:19
procedure lately that’s been getting the
6:21
most traction and you know had the most
6:23
requests from our members so you know
6:26
more to come on that but I will just put
6:29
in a quick plug to anyone listening if
6:31
you have any outcomes data
6:35
from your facility specifically on total
6:38
shoulder we would welcome that
6:40
information
6:41
CMS is very interested in you know
6:45
seeing actual data and like I said you
6:48
know how the procedures how many
6:51
procedures are being performed we can
6:52
typically pull that kind of information
6:53
we have access to volume data but they
6:56
are looking at outcomes data you know so
7:00
they can show that they’ll be safe
7:02
procedures to be performed in ASC so any
7:05
help we can get we would welcome that
7:09
very helpful and and just you know it’s
7:12
a couple follow-up questions there for
7:14
from a context perspective you said
7:16
there’s four procedures in the final
7:18
rule how does that compare to previous
7:20
years
7:21
so it’s fairly consistent unfortunately
7:24
and that’s part of the reason that we
7:27
wanted this new more formal nomination
7:29
process where you can eventually go on
7:31
the CMS website submit codes through a
7:34
portal and then CMS will have to respond
7:36
to those codes because in the past you
7:39
know we’ve you know gone and presented
7:41
to CMS and it’s kind of like
7:44
you know you don’t hear back and then
7:47
and then it’s either in the proposed
7:49
rule or it’s not
7:51
um and anywhere from zero procedures
7:54
added to we did have you know a couple
7:56
years where we got like 17 codes those
7:59
were typically in years where we had
8:01
like certain Specialties that were
8:02
focused on so
8:04
um you know you may remember that a few
8:06
years ago we had some cardiovascular
8:08
codes added to our list so we got 17
8:11
codes I think
8:13
um at that time
8:15
um but they were all within the same you
8:17
know specialty but it’s typically you
8:19
know between I’d say four to six codes a
8:22
year so slow movement
8:25
um unfortunately but we are like I said
8:29
being more pro at planning on being more
8:31
proactive in 2023 we kind of took a
8:34
little bit of a Hiatus
8:36
um taking surgeons to meet with CMS
8:39
medical officers during the pandemic but
8:42
we are picking that up and resuming that
8:45
in 2023
8:48
so so slow but steady progress
8:51
um and it sounds like hey at least
8:53
there’s line of sight into a new more
8:56
structured hopefully more visibility uh
9:00
nomination process
9:02
until then you mentioned that ask is is
9:04
continuing to help us fill that Gap
9:07
um how does aska go about determining
9:10
what you guys put on your recommendation
9:12
list from a CPT code perspective
9:14
absolutely so we do a survey of our
9:20
members every year and we ask for them
9:23
to submit codes to us that they would
9:26
like to be considered and then we always
9:29
ask for all of those procedures we also
9:33
go to look at the claims data that we
9:37
have access to for private payer claims
9:41
and we look to see how often those codes
9:45
are being done in the outpatient setting
9:47
both ASCS and Hospital outpatient
9:50
Apartments I would argue hopefully most
9:52
in our space would argue that in terms
9:55
of safety and quality ases and Hospital
9:58
outpatient apartments are pretty much
10:00
one in the same so you know we argue
10:03
consistently to CMS that anything that
10:06
is allowed to be performed in a hospital
10:08
outpatient apartment should also be
10:10
allowed on the ASC cover procedure list
10:13
but it’s all based on member
10:16
recommendations and then in addition to
10:18
that we will include other procedures
10:22
that we see that are being done in high
10:24
volume in case you know we just didn’t
10:26
hear from those folks those doctors who
10:29
are performing you know other procedures
10:32
so it’s usually high volume and anything
10:35
that is requested from membership
10:38
great
10:40
um and another piece I want to touch on
10:41
that that you mentioned was the outcomes
10:45
data that that seems to be pretty
10:47
important
10:48
um in in the CMS decisioning what what
10:52
type of outcome data or outcome tracking
10:54
have you seemed to be most effective
10:56
because this this outcome term can mean
10:59
different things I mean different folks
11:00
and and it can be hard in terms of hey
11:03
what really is going to hold up under
11:05
the scrutiny it’s tough too because I
11:07
think sometimes CMS doesn’t even know
11:09
what it’s looking for
11:11
um we you know provided them with a
11:14
couple of research studies in the past
11:16
two years of rulemaking uh specific to
11:19
total shoulder total ankle and a spine
11:22
fusion code and it was successful two
11:26
years ago keeping those codes off of
11:28
going back on the inpatient only list
11:30
some listeners may remember that there
11:32
were huge sweeping changes made during
11:34
the final year of the Trump
11:35
Administration and then the Biden
11:37
Administration in its first year kind of
11:40
pulled back a lot on those changes and
11:43
so they were planning on adding like
11:45
total shoulder total ankle and some
11:48
spine codes back to the inpatient only
11:50
list we are success possible keeping
11:51
those off and thought that you know the
11:54
research that we shared was probably
11:55
compelling and helpful with that but
11:57
then when we shared similar research and
12:00
information you know this year or last
12:03
year for
12:04
2023 rule making you know it wasn’t as
12:07
compelling
12:09
um part of the reason that we need to go
12:10
meet with CMS is because
12:13
we want further guidance in terms of
12:16
what is going to move the needle in the
12:20
final rule they said that the data
12:22
wasn’t compelling because I guess it
12:24
wasn’t enough volume to look at and then
12:27
they also made this weird argument about
12:29
you know is it transferable across all
12:32
surgery centers and I didn’t exactly
12:34
understand what that meant like you know
12:36
an eye center is not going to all of a
12:38
sudden start doing total shoulder
12:39
surgery but anybody who’s already doing
12:42
total joint Replacements you know I have
12:44
full confidence in our facilities that
12:46
those who are doing total joint
12:48
Replacements are safe and effective and
12:50
could add to total shoulder Medicare
12:52
volume to that mix so like I said it’s
12:55
kind of unclear what exactly they want
12:57
and of course you know the outcomes data
13:00
for each type of procedure varies
13:03
um you know so for a lot of these joint
13:06
Replacements they’re looking to see
13:09
um you know infections they’re looking
13:11
to see
13:13
um you know was there a follow depending
13:15
on the surgery was there a follow-up
13:16
required
13:18
um so you know really any data that that
13:22
we get our hands on we share with CMS
13:25
because anything is better than better
13:27
than nothing and like I said it’s still
13:29
kind of unclear to US based on the
13:31
responses that we’ve gotten from them in
13:33
previous meetings what exactly they’re
13:35
looking for
13:36
sure okay well shifting gears on you a
13:40
little bit uh maybe more of a kind of
13:42
positive glass is half full perspective
13:44
the ruling for my understanding does
13:46
include some complexity adjustments
13:49
um for certain code code combinations I
13:51
believe can you explain what the policy
13:53
does
13:55
um you know and talk about the benefit
13:56
of that for the industry sure absolutely
13:59
so this was a big win for ASCS and a
14:03
good starting point for this policy so
14:06
for Hospital outpatient apartments for
14:07
some time they’ve had this complexity
14:10
adjustment so CMS takes the you know
14:14
primary surgical code that’s being done
14:16
and then an add-on code that’s done in
14:19
conjunction with that and they bump up
14:21
you know the reimbursement rate because
14:24
they’re saying that the add-on code
14:26
changes the complexity and the cost of
14:30
Performing that procedure so typically
14:33
um for every you know run-of-the-mill
14:35
case add-on codes are not separately
14:38
payable they’re they’re N1 payment
14:40
indicator and there’s no additional
14:42
reimbursement available but CMS has
14:46
found like I said these code
14:47
combinations for 2023 there are 55 of
14:50
them in the ASC setting for which the
14:54
add-on is going to you know increase
14:57
that reimbursement for ases so
15:00
um you know it’s it’s a start there are
15:02
certainly other code combinations we’re
15:04
looking to get added there’s not really
15:06
a ton of spine on there and we know for
15:08
a fact that there are a lot of spying
15:10
code combinations with an add-on that
15:13
you know certainly are more complex and
15:15
costlier so one example I’ve been giving
15:18
is removal of thyroid so the primary
15:20
code is
15:22
60240 and there’s often an add-on with
15:26
that
15:27
60512 that would typically not be
15:31
reimbursed under under the 2022 and you
15:34
know prior Medicare policies
15:37
um but CMS has found that when those
15:39
codes are done in combination it’s
15:41
costlier more complex and so now this
15:44
new C code that CMS has established is
15:48
c7555 and it has a reimbursement rate of
15:51
around 4 200. so basically an increase
15:54
of you know 17 1800 because of you know
15:59
those codes being done in combination so
16:02
ask is going to put out more resources
16:05
we also have some already available on
16:07
our website so you can see which code
16:09
combinations are already
16:12
um you know going to get this new
16:14
complexity adjustment but as I said
16:17
we’re really going to be pushing for a
16:19
lot more code combinations in the future
16:21
specifically in the spine area
16:25
great sounds like some something we can
16:27
build on yeah uh can you tell me a
16:30
little bit about Quality Reporting and I
16:32
understand there’s a linkage between
16:33
medicare’s Quality Reporting and and
16:37
payments and and can you tell me a
16:38
little bit about how that how that
16:40
linkage works and what the implications
16:41
are sure
16:43
um so I don’t know if everybody
16:45
um who’s listening realizes this but
16:47
updates to our Quality Reporting program
16:49
are always found in our payment rule
16:52
because there could be a two percent
16:54
penalty if you fail to uh report under
16:58
the ASE Quality Reporting program so
17:01
um in this year’s final rule there
17:03
weren’t a ton of significant changes
17:06
um you know we did
17:08
um kind of push back ASC 11 which is
17:11
this cataract Improvement in patients
17:14
visual function within 90 days measure
17:16
it’s one that we’ve been
17:18
um
17:19
push advocating against I guess you
17:21
would say for almost a decade now
17:24
because it’s really a physician measure
17:26
it’s not a facility level measure
17:29
um and so we’ll continue to push back on
17:31
that but I did just want to let everyone
17:33
know as a reminder that we have a few
17:37
outcomes measures that are back in our
17:39
Quality Reporting program as of uh 2023
17:43
data collection so ASE one through four
17:46
they were you know the first measures
17:48
that were added to our program back in
17:51
2012 when it was first initiated so
17:55
Burns Falls wrong events and Hospital
17:58
transfers just a reminder that you have
18:01
to collect data for those again and I
18:04
know we’ve been getting a lot of
18:05
questions that ask us so you know you
18:07
might get a lot of questions too it is
18:10
not claims based anymore so you used to
18:12
submit those on your fee for service
18:14
Medicare claims that’s no longer the
18:16
case now you’re collecting that data for
18:19
all of your patients and then you’ll be
18:21
submitting it through the web-based
18:23
portal that CMS has next May so just you
18:27
know wanted to remind everyone on that I
18:29
know we’ve been getting a lot of
18:30
questions so I’m guessing that um you
18:33
might be getting some questions as well
18:37
absolutely fantastic
18:40
um anything else from a final ruling
18:42
perspective from a kind of macro topic
18:45
perspective that our listeners should be
18:46
aware of or keep an eye on
18:49
I think it’s just always important to
18:50
know that you know we are a small Cog in
18:54
you know this larger machine and you
18:59
know really there’s a lot of discussions
19:00
and Rumblings happening right now about
19:02
a complete overhaul and more significant
19:05
changes to the Medicare program I’ve
19:07
talked with a lot of folks at CMS about
19:09
this and I would love to be part of
19:11
those discussions because I think that
19:12
there are definitely improvements that
19:15
could be made
19:16
um but you know I was just listening to
19:18
the medpack meeting a few weeks ago and
19:22
I think that they said that we are 0.5
19:24
of the Medicare spend ases are so you
19:29
know although we think you know
19:31
obviously they’re you know 6100 CMS
19:34
certified ASCS and we’re saving Medicare
19:37
you know billions of dollars a year but
19:39
we’re still a very small piece of the
19:41
puzzle but I think that we you know do a
19:44
good job at ASCA even even though we’re
19:46
a small piece of the Medicare puzzle you
19:48
know kind of hitting above our weight or
19:52
you know getting a lot of
19:54
um you know positives for our industry
19:56
so
19:58
um
19:58
go love it and appreciate appreciate all
20:00
that you do and Alaska does on on behalf
20:03
of the industry
20:05
um Kira final question for you and we
20:09
asked this for for all of our guests
20:10
every week
20:12
what’s one thing our listeners can do
20:14
this week over the near term to improve
20:16
their surgery centers
20:18
okay it’s a little self-serving
20:21
um but ASCA is uh hosting our first
20:24
fly-in in three years
20:26
um and I would say you know if at all
20:30
possible if you can come and participate
20:32
in our you know fly-in also known as our
20:34
national advocacy day you know really
20:36
that’s how you’re going to help make an
20:39
impact not only for your facility but
20:40
the industry as a whole is getting in
20:43
front of your elected officials and you
20:45
know telling them your story and how
20:47
great you are that’s how we really get
20:49
through to them if that’s not feasible I
20:52
would say you know host a facility tour
20:54
and bring folks in you know I would I’m
20:57
not a clinical person and I could never
20:59
give advice on you know how to run your
21:01
surgery center I’m also not you know
21:02
business person in that sense but
21:04
um you know what we do here from elected
21:06
officials who you know go to bat for us
21:09
in Congress or in your States is that
21:13
really hearing your story what you’re
21:15
doing and all the great care you’re
21:16
providing is you know really what
21:19
resonates with them and gets them to
21:20
either sign on to our legislation or
21:22
help you know push different wins for
21:25
the industry so that’s that’s my plug I
21:27
you know I’d love for you all to bring
21:29
people into your facilities or come to
21:30
DC if you have the ability and for folks
21:33
that are interested in learning more
21:34
about the flying day and what that
21:36
entails uh where can they get some
21:38
information on that sure you can reach
21:41
out to me you can go to our website
21:45
ascassociation.org
21:47
and you can like like I said feel free
21:50
to reach out to me follow us on all the
21:52
social media platforms we have more
21:54
information there as well
21:56
fantastic Garrett thanks so much for
21:58
joining us today yep thank you
22:02
[Music]
22:05
as always it has been a busy week in
22:07
healthcare so let’s jump right in our
22:10
first story of the New Year comes from
22:11
Becker’s ASC review with the end of the
22:14
year comes a bunch of Articles recapping
22:16
2022 and looking ahead to the new year
22:19
and this article is the latter Becker
22:22
has published a write-up titled five
22:24
Trends ASCS need to know in 2023 and
22:27
here’s the Scoop Trend number one is
22:30
value-based care with low-cost high
22:33
quality procedures ASCS are set up for
22:35
success as Healthcare transitions to
22:37
this payment model
22:39
ases have always offered high quality
22:41
results so this payment model will bode
22:43
well for the industry
22:45
and minutes from optum’s investor
22:47
meeting in October they share that their
22:49
revenue per consumer has grown 31 and
22:53
they attribute that success to the
22:55
increasing number of patients served
22:57
under value-based care relationships and
23:00
if you do look at their minutes and you
23:02
do a quick search for value-based care
23:04
you’ll see that that term comes up over
23:07
a dozen times which is very telling
23:10
Trend number two is physician pay cuts
23:13
medicare’s physician fee schedule final
23:15
rule will reduce the conversion factor
23:18
by
23:19
4.48 to which is down to 33 dollars and
23:24
six cents there have been concerns that
23:27
the cut will push Physicians away from
23:29
ases and to larger Health Systems will
23:31
also lead to declining availability of
23:34
Physician Services
23:36
Trend number three is Staff shortages
23:38
now this is not news to anybody this is
23:42
one of the largest concerns for ASC ASCS
23:44
right now we’ve we’ve talked about it a
23:46
couple times
23:47
um there’s unfortunately no secret
23:49
solution here as you can’t cut Corners
23:51
with higher and qualified staff and vmg
23:55
health shared that many ASCS will have
23:58
to spend a quarter or more of their net
24:00
operating revenue on employees alone as
24:02
we look to next year so focus on
24:05
satisfaction and retention and
24:07
recruitment as much as you can
24:10
Trend number four is physician ownership
24:12
if there are employed physicians at your
24:15
ASC that are not currently stakeholders
24:18
you might want to consider including
24:20
them this will incentivize all
24:22
Physicians who work with you to not only
24:24
strive for their own day-to-day
24:26
satisfaction and good pay but to also
24:28
strive for the longevity and success of
24:31
the ASC and obviously with more cases
24:33
comes more revenue and more stability
24:37
Trend number five last but not least is
24:39
stagnant reimbursement rates ases are
24:42
paid much lower rates than Hospital
24:44
outpatient departments for the same
24:46
exact procedures so you need to keep a
24:49
close eye on payer behavior and really
24:51
build one-on-one relationships with your
24:53
payers as much as you can
24:55
and there you have it those are the five
24:57
Trends from Becker’s to keep an eye on
24:59
as we are officially now in the new year
25:03
our next piece of news comes from
25:05
outpatient surgery magazine and I
25:07
personally think this story is really
25:09
cool
25:10
um an airport style security scanner at
25:13
the University of Iowa Hospitals and
25:15
Clinics is saving tens of thousands of
25:17
dollars worth of valuable instruments
25:19
from accidentally entering the waste
25:21
stream
25:22
after each surgery bags of trash are
25:25
removed from the or they are run through
25:28
Environmental Services placed on a
25:30
conveyor belt and scanned each bag is
25:33
numbered to identify the room and
25:35
surgery from which it came from and if
25:37
the scan detects an instrument a nurse
25:39
is called to identify it and process it
25:41
correctly through the Sterile Processing
25:43
Department
25:45
this idea alone has recovered thirty
25:48
five thousand dollars worth of lost
25:50
instruments in its first nine months so
25:53
as we’re constantly thinking about ways
25:55
to reduce waste and save money this idea
25:58
checks both of those boxes
26:00
now I’m not sure how much the conveyor
26:02
belt cost but I’d imagine with an
26:05
average savings of roughly thirty eight
26:07
hundred dollars per month it will pay
26:10
for itself pretty quickly if it hasn’t
26:12
already
26:15
our third story comes from Med City News
26:18
and they put together a piece on seven
26:20
rules hospitals should follow when
26:22
adopting new tech and five of those
26:24
rules really apply to ASCS as well
26:28
if your surgery center is considering
26:30
adopting new technology in 2023 whether
26:33
it’s patient texting or an EHR or a
26:35
patient estimating tool keeping these
26:38
rules in mind will help you
26:39
significantly in the implementation
26:41
process
26:43
so first planning should begin during
26:45
the sales process work with your vendor
26:48
to set clear expectations timelines
26:50
implementation plans any hidden costs
26:53
and everything else don’t hold back with
26:56
your questions and don’t hold back on
26:59
pushing your render for Clear answers
27:01
until you’re comfortable with them
27:04
tip number two clearly Define governance
27:07
structures
27:08
um so by this they mean just organize a
27:10
leadership team for the project and make
27:13
sure members of the team have clear
27:15
roles and responsibilities now that
27:18
might seem like a no-brainer but it
27:20
shouldn’t be something that’s just
27:21
assumed we want this written down
27:24
um and everyone needs to buy in
27:27
tip number three is always communicate
27:30
everyone involved should have a clear
27:31
understanding of who’s doing what at all
27:33
times and why they’re doing it and
27:36
create an actual communication plan and
27:38
provide regular updates
27:41
tip number four is to prioritize
27:43
stakeholder alignment leaders of both
27:46
your ASC and the vendor must be
27:49
transparent with each other Express
27:51
buy-in and commit to success without
27:53
that stakeholder alignment the whole
27:56
process could fall out of whack
27:59
and the last tip here training is a
28:02
necessary investment and I couldn’t
28:04
agree more this is a huge one we just
28:06
did an episode on nursing informatics
28:08
which kind of ties in exactly to what
28:12
this tip is saying without proper
28:14
training end users usually don’t feel
28:16
comfortable adopting a new technology or
28:18
won’t be satisfied with it so early on
28:21
in the tech adoption process you should
28:23
designate who is responsible for
28:25
creating and delivering training
28:27
materials and assign power users to each
28:30
department without those power users and
28:34
without proper training
28:36
the carrier receive it the care patients
28:39
are receiving could be impacted and
28:41
patient safety could be impacted so make
28:44
sure you invest in training
28:47
and to end our new segment on a positive
28:49
note Dr Steve lomay saved two lives
28:52
during a half marathon recently Dr lomae
28:56
was running the marathon himself when he
28:58
saw Gregory Gonzalez a fellow Runner
29:00
fall and hit his head he immediately
29:03
began CPR until an ambulance arrived
29:07
then at the Finish Line another fellow
29:10
Runner Michael heilman also fell in his
29:13
head and the same chain of events
29:15
occurred Dr Lemay began CPR until an
29:17
ambulance arrived
29:19
both men ultimately had blockages that
29:21
led to their cardiac arrest and they
29:24
received stents in their coronary
29:25
arteries and are perfectly fine and the
29:28
three men plan to run the half marathon
29:31
together in 2023.
29:34
and that news story officially wraps up
29:36
this week’s podcast thank you as always
29:39
for spending a few minutes of your week
29:41
with us make sure to subscribe or leave
29:43
a review on whichever platform you’re
29:45
listening from I hope you have a great
29:47
day and we’ll see you again next week
29:52
[Music]
29:55
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