This Week in Surgery Centers: Nine News Stories Shaping the ASC Industry

Kathy Wilson – Accurately Tracking & Reporting on the “Wrong Site” Measure

Here’s what to expect on this week’s episode. 🎙️

For today’s episode of This Week in Surgery Centers, let’s dive into nine noteworthy news stories that have been making waves in the industry!

➡️ With so many patients losing weight, experts wonder if drugs like Ozempic and Wegovy will increase the need for orthopedic procedures in the short term. This is just another factor, albeit cultural, that is driving case volume for ortho and total joint procedures.

➡️ Medicare has introduced a new online ASC procedure request process. The deadline to submit for 2025 is March 1, 2024 – so now is the time to voice your opinion.

➡️ How can you counteract rising supply costs? Tip 1 is to have candid conversations with your vendors. Tip 2 is to analyze and dissect every minute of the PreOp, OR, Anesthesia, and PACU workflow and see where you lack efficiency.

➡️ The Office for Civil Rights released its biannual update on HIPAA violations: healthcare organizations across the country posted 336 breaches of PHI affecting 500 or more individuals for the second half of 2023. 88% were due to a hacking/IT incident.

➡️ Despite CMS decreasing the physician fee schedule conversion factor by 3.37% in 2024, GI doctors are choosing to properly care for their Medicare patients despite operating a loss. A choice that no doctor should ever have to make.

➡️ HST Pathways has been ranked #1 in the 2024 Best in KLAS: Software & Services Report. Being named a Best in KLAS winner signifies that an organization has surpassed the highest standards of performance, reliability, and, most importantly, client satisfaction.

➡️ Medscape released its 2023 Nurse Career Satisfaction Report titled “Fulfillment and Frustration.” Nurses find helping people to be the most rewarding part of their job, yet they find workplace politics to be the least rewarding.

➡️ The Joint Commission and AAAHC shared simple hacks to improve accreditation surveys. A few tips: integrate patient safety into your culture, stay current with compliance measures, focus on previous deficiencies cited, and conduct mock surveys.

➡️ Iowa hospice nurse Tiffany McArdle went above and beyond the call of duty by walking through a blizzard to reach a patient after the patient’s wife had called in, saying that her husband had had a change in condition. Unfortunately, the patient did pass away; however, thanks to Tiffany, the sheriff was able to plow the driveway and make sure the patient’s children could get to him to say their final goodbyes.

Sources: Becker’s Healthcare, Ambulatory Surgery Center Association, HST Pathways, Medscape, Outpatient Surgery Magazine, and The Daily Nurse.

Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details.

Episode Transcript

0:27
Hi, everyone.

0:28
Here’s what you can expect on today’s episode.

0:31
We are going to do things a little differently this week.

0:34
Instead of having our guest segment and then ending with the news recap, we’re going to spend our time going through 9 news stories that are shaping the ASC industry.

0:43
We’ll cover Ozempic and orthopedic surgeries, how you can combat rising supply costs, Hippa’s biannual update, simple hacks to improve accreditation surveys, and much more.

0:56
We’ll also bounce between industry trends, clinical trends, articles looking back at 2023, and articles looking ahead to what 2024 will bring.

1:05
Hope everyone enjoys the episode, and here’s what’s going on this week in surgery centers.

1:14
As always, it has been a busy week in healthcare, so let’s jump right in.

1:19
Unless you’ve been in hiding for the past year, you are very familiar with the sudden popularity of drugs like Ozempic and Wogovi and their very similar counterparts.

1:29
CNBC actually reported that in just a three month window from October to December 2023, healthcare providers wrote more than 9 million prescriptions for these drugs, which is a 300% increase from years prior.

1:45
Now experts are wondering if this trend will also positively impact orthopedic surgeons.

1:52
As patients continue to lose weight, barriers to surgery such as high patient BM is could begin to become less common.

1:59
The American Academy of Orthopaedic surgeons will need to either double their total joint caseload or the number of surgeons will need to increase by 10% every five years to meet the growing demand for surgery.

2:14
Kevin Stone is an orthopedic surgeon at the Stone Clinic in San Francisco and he shared that weight loss drugs will help people be much more active, which will drive more muscular usage, which will drive more patients to experience more injuries and more desire to have pain free joints.

2:32
And then Brian Gottwerker, a neurosurgeon at the Craniospinal Center of LA, shared that he recommends that patients stop the meds at least one week prior to any surgeries just until there is more research done about how they could impact a patient while under anesthesia.

2:49
So if you are on one of these weight loss drugs, that is his recommendation just because you know there hasn’t been a ton of research done yet.

2:58
He also shared the benefits of weight loss for patients who experience chronic pain, but does caution everyone to move with a healthy level of skepticism when choosing if the medication is right for you.

3:08
So there’s a lot we don’t know, and this article is just kind of summarizing different viewpoints and things to consider.

3:15
But it is very interesting to hear about one other cultural factor that will likely increase the volume of orthopedic procedures in the short term.

3:26
All right, switching gears, Medicare has introduced a new ASC procedure request process.

3:33
So CMS has officially launched their Stay with me here.

3:37
It is a long name.

3:38
Their ASC Covered Procedures list Pre proposed Rule Recommendation Request process which is a new way to submit codes for consideration.

3:50
Now the deadline to submit for 2025 is actually March 1st, 2024.

3:55
So now is the time to voice your opinion and previously it’s really been a mystery as to how CMS decides which procedures to add to their ASCCPL each year.

4:07
Obviously ASCO is a huge voice for the industry.

4:10
They provide tons of comments and feedback, and they even typically just use trends found in its Annual Procedure List survey, sent to its own members to determine which codes should be pursued.

4:20
So anyway, here’s how to participate.

4:23
First, you want to register the the acronym is MEARIS, so you want to register as a user.

4:31
Put all the links in the episode notes, but it stands for Medicare Electronic Application Request Information System.

4:38
So you just need to register as as a user it just takes a second and then you just need to complete the request form using the codes you want to be approved and then any supporting documents are helpful as well.

4:49
So I’ll put all the links in the episode notes and I’ll also link to Aska’s article which is just full of tips and other considerations when you are submitting codes and a bunch of other info.

4:59
So highly recommend reading all these articles prior to submitting.

5:02
And again, the deadline is March 1st, so if you do plan to make any suggestions, now is the time.

5:09
So Next up, Becker’s ASC spoke with Steven Winkler, who is the executive director of an orthopaedic surgery center in Baton Rouge, LA.

5:19
And they talked about how ASC can try to counteract rising supply costs.

5:24
The most notable tips that Steven shared was to have a candid conversation with your vendors asking them directly, Are there any other ways to save on our costs, perhaps generic first branded products.

5:36
And then for your implant vendors, if you use multiple, you know, you could have a conversation with them asking them how would switching to 1 vendor impact the price of your implants.

5:46
So two very tangible tips there.

5:48
And then he also recommended really analyzing how you can make your OR more efficient and increase throughput.

5:55
And I want to expand on that one just a little bit because I think it’s so important to the longevity of every surgery center that you are being surgically precise with how you run your operations and OR efficiency and throughput is a huge core piece of that.

6:11
So between your practice management software and your EHR, you really need to be collecting every data point you possibly can so that you can be completely data-driven and how you operate and move patients through your facility.

6:24
So analyzing start times and end times gives you the ability to dissect what’s going on during pre, OP OR anesthesia, pacu etcetera and also calculate the total minutes in each area.

6:37
So this will help you understand down to the minute any potential cost or time savings.

6:42
And then you can regularly look at turnover times, case direct duration, staffing levels and supply usage, of course, which will give you the insights that you need to counteractorizing supply costs, which are largely out of your hand.

6:54
So I love the tips that Steven Winkler gave in this article, but I think taking it one step further and, you know, really understanding your case costs will help you get as much control over your supply costs as you can.

7:09
All right, let’s talk about Phi and HIPAA.

7:12
So the Office for Civil Rights released their biannual update on HIPAA violations.

7:18
Healthcare organizations across the country posted 336 breaches of Phi, affecting 500 or more individuals for the second-half of 20/23/88.

7:32
Percent of those 336 breaches were categorized as a hacking or IT incident, 10% were categorized as unauthorized access or disclosure, and then 1% was theft and 1% was lost.

7:49
Now, this article came from ASC Focus, and they actually shared really two interesting examples.

7:54
The first was Saint Joseph’s Medical Center, so the OCR began investigating after The Associated Press published an article featuring the medical center’s response to the COVID-19 pandemic.

8:07
Photographs and patient info were included in the outlets reporting, including COVID-19 diagnosis, current medical statuses, and treatment plans.

8:16
So the OCR determined that three individuals, Phi was disclosed in the article without first obtaining their written authorization.

8:24
And after their investigation, Saint Joseph’s Medical Center agreed to an $80,000 penalty in a corrective action plan with two years of monitoring.

8:34
And as we know, $80,000 penalty is peanuts compared to what most organizations end up having to pay as a fine.

8:41
The second example that the article shared was about the Monte Fiori Medical Center.

8:46
So the New York Police Department informed the Medical Center that it found evidence of theft of a patients Phi.

8:52
The Medical Center conducted an internal review and discovered that two years prior, one employee stole the electronic Phi of more than 12,000 patients and sold the information to an identity theft ring.

9:05
After the theft was discovered, the Medical Center filed A breach report with the OCR and then, nine years after the initial contact from the police, the center agreed to a $4.75 million settlement, a corrective action plan and two years of monitoring.

9:22
So this is just your reminder that first, these breaches come in all shapes and sizes, right?

9:27
That first example was the press publishing a photo, and then the second example is an internal employee selling Phi.

9:35
And then it is also your reminder that if you have not done so recently, please update your policies and procedures to help prevent any breaches from taking place at your surgery center.

9:46
All right.

9:46
This next story I found especially interesting.

9:50
So despite ongoing physician fee cuts from Medicare, some gastroenterologists are making the tough decision not to drop patients even though they’re experiencing such high declining reimbursements.

10:02
So just your reminder that CM S s physician fee schedule conversion factor is set to decrease by 3.37% in 2024.

10:13
So Doctor Singhal is a gastroenterologist at SSM Health in Oklahoma City and she shared the following quote.

10:20
My independently owned practice is still accepting Medicare and Medicare Advantage insurance plans.

10:26
We continue to accept these plans because it is unfair to the patient to not have access to specialists in healthcare due to constantly declining reimbursements.

10:36
Often times, physician and practices are taking a loss as compared to commercially insured patients by seeing Medicare patients.

10:44
A large amount of the patient population is covered by Medicare plans and it will be unfortunate to exclude the patient population.

10:52
Other doctors interviewed shared the same sentiment.

10:56
Doctor Kokar in Illinois said despite the reimbursement issue, we have an obligation to serve all patients equitably.

11:04
Delayed diagnosis in this population often leads to downstream morbidity, which increases the burden throughout the entire healthcare system.

11:13
So I found this story both equally frustrating and inspiring.

11:18
We are all constantly talking about the financial aspect of running an ASC or a practice.

11:23
How can we cut procedures that aren’t profitable?

11:25
How can we improve our bottom line and cut costs?

11:28
And when faced with the situation that financially on paper has a clear answer, which is to cut Medicare patients, which is awful.

11:36
Doctors are relying on their morals and saying no, and I hope that CMS is paying close attention to this and will remember that the patient comes first and without physicians willing to provide care, the entire population will pay the price.

11:51
So kudos to the GI doctors that are continuing to do what’s right for their communities.

11:58
This next story feels a little like the movie Inception, but I think it’s important to share that HST Pathways has been ranked number one in the 2024 Best in Class Software and Services report.

12:12
Now, normally I really don’t like to talk about HST, despite this being a podcast brought to you by HST.

12:19
However, being awarded the 2024 Best in Class award in the AST Solutions category is a significant achievement.

12:27
It’s no easy feat, and if you know a different company had won, I would be reporting on it.

12:32
So why not show some love for HST as well?

12:36
Now if you’re not familiar, the 2024 Best in Class awards are renowned throughout the healthcare industry for recognizing technology leaders who excel in creating solutions that their clients love and helping healthcare professionals provide better patient care.

12:52
And so being named a Best in Class winner signifies that an organization has surpassed the highest standards of performance, reliability and most importantly, client satisfaction.

13:03
So on behalf of everyone at HST, I just want to give a heartfelt thank you to every member of the HST Pathways team, our partners, and most importantly, our customers.

13:14
Your support and invaluable feedback have been crucial to our success and we are deeply grateful for the opportunity to play a supporting role in enhancing the quality of care provided to your patients.

13:28
OK, enough HST Talk.

13:31
Medscape released their 2023 Nurse Career Satisfaction Report and they titled it Fulfillment and Frustration.

13:41
So Medscape surveyed mostly full time RNS and then LPNS Nurse practitioners, clinical Nurse Specialists, CRN AS and midwives, and 87% of those interviewed were female.

13:54
So here are a bunch of takeaways.

13:57
They’re in no particular order, so right, there’s five different things I pulled out.

14:03
So the first is simple question, what do you find most rewarding?

14:07
The top 2 answers or the top?

14:09
The first answer was the number one answer by a landslide and it was helping people.

14:14
And then the second one was a good work life balance.

14:18
And then what do you find least rewarding?

14:20
The number one answer was workplace politics and the second was the pay.

14:27
They also did a segment on verbal abuse and the biggest perpetrators in order are patients, visitors, Co workers, physicians and then lastly administration.

14:38
So the number one perpetrator of verbal abuse towards nurses came from patients.

14:46
And then in regard to sexual harassment, nearly 60% of nurses said when they did experience harassment, abuse or misconduct, they did not believe that it was handled well by those in charge.

14:56
So this is an interesting one.

14:58
I think it’s incredibly important that every surgery center has a policy in place.

15:03
If there is a nurse, a doctor, anybody at your facility that comes to you in regards to a sexual harassment, abuse or misconduct complaint, it’s very important that we handle that appropriately, especially since nearly 60% of nurses said in their experience it has not been handled appropriately.

15:22
And then lastly, when asked would you choose nursing again, the majority did say yes, but 15% said they would not choose to be a nurse if they could go back in time and you know, do the whole thing over again.

15:36
But when pressed further that you saw that 15% segment who said they wouldn’t do it again when they followed up with them, the majority would still want to be in the healthcare industry, but perhaps maybe on the dental side or administration or teaching.

15:50
So I always find these surveys really interesting and obviously we talk ad nauseam about all the staffing issues that are taking place.

15:58
So looking at reports like this and really seeing industry trends and how the majority of nurses feel, you know, your staff members might feel this way, they just might not feel comfortable or whatever the reasons might be voicing these things to the leaders at their facility.

16:14
So it’s very important that we look at reports like this, look at the majority, look at the trends and try to get ahead of a lot of these items.

16:21
So as always, I’ll link to the full report in the episode notes and I highly recommend reading it thoroughly.

16:27
OK, this next article, I was really excited.

16:30
I think the AORN, you know, outpatient surgery magazine, they always publish amazing stuff, but this one I thought was super helpful.

16:37
So the Joint Commission and triple AHC experts are sharing simple hacks to improve accreditation surveys.

16:44
So a new year means a new focus on surveys.

16:47
And while these surveys are definitely stressful, they do lead to better outcomes, more satisfied patients, and ultimately more income to sustain the center.

16:58
So Cheryl Piston is AAA H CS Clinical Director, and she suggests emphasizing a survey mindset every day so that you are always prepared for the next survey cycle.

17:09
And here were a few of her key tips.

17:12
You want to integrate a commitment to patient safety into your culture, stay up to date with compliance measures, review previous deficiencies cited, and focus on those.

17:24
Conduct A mock survey, encourage open and transparent communication, and then provide ongoing staff training and education.

17:35
And then Julie Lynch, director of AAA H CS Institute for Quality Improvement, says AAA H CS deficiency data for last year revealed AS CS most frequently failed survey elements were these five items, emergency preparedness, credentialing and privileging, infection prevention and control, documentation management and quality improvement.

18:00
So this wasn’t in the article, but if I was AAA HC and I knew that these were the five issues most ASC struggled with the following year, I would be looking at these five areas extra closely.

18:12
So I feel like they gave us, you know, maybe a little bit of their playbook here of what areas they might be paying extra close attention to this year.

18:20
And then Elizabeth Even, who is the Senior Assistant Director at the Joint Commission, suggested a focus on basic infection control practices as deficiencies within AS, CS infection prevention and control plan were major issues that the Joint Commission surveyor cited in 2023.

18:39
So several opportunities often scored low in ASC surveys were proper hand hygiene, disinfecting medication, vials and IV hubs prior to medication administration, and lastly availability of proper personal protective equipment for staff.

18:58
So what I’ve shared is really just the tip of the iceberg for this article.

19:02
There are so many other tips and advice and I highly recommend giving it a read And to end our new segment On a positive note, Iowa Hospice nurse Tiffany McArdle walked through a Blizzard to reach a patient after the patient’s wife had called in saying that her husband had a change in condition.

19:24
Unfortunately, right at that moment they were experiencing a Blizzard and below 0 temperatures.

19:31
Tiffany said.

19:33
I knew they lived alone, no other family nearby.

19:36
They were in the countryside, so I knew I needed to get there.

19:39
You get very close to these families and the patients, and we go to wherever our patients call home.

19:44
That’s where we go.

19:46
Tiffany drove as close as she could to the house, but ultimately ended up walking in snow up to her knees.

19:53
And after an hour of walking when the patients wife opened the door, she started crying and was just so overwhelmed with gratitude that Tiffany went above and beyond to make it to her.

20:04
Now, unfortunately, her husband did pass away.

20:07
However, thanks to Tiffany, the sheriff was able to plow the driveway, which made sure the patient’s kids could get to him to say their final goodbyes.

20:15
So just another amazing story of a nurse going above and beyond the Call of Duty in order to provide the best patient care she possibly could.

20:27
And that news story officially wraps up this week’s podcast.

20:30
Thank you, as always, for spending a few minutes of your week with us.

20:34
Make sure to subscribe or leave a review on whichever platform you’re listening from.

20:39
I hope you have a great day and we will see you again next week.