ASC Industry Awareness
ASC’s Relative Safety One of Many Reasons for Solid Growth
ASCs in the United States must consistently overcome the cultural bias that bigger is nearly always better. One way ASCs continue to demonstrate their value is through relative safety studies. The risk of complications is low in orthopaedic surgeries in ASCs, though upper extremity surgeries carry a little more risk. Patients rated ASCs higher in safety than hospital-based day surgery centers, according to a new Leapfrog Group report. Safety is not the only reason ASCs continue their steady growth pace. ASC fee schedules, migration of approved procedures to ASCs from HOPDs, quality of care, and advances in technology also drive ASCs forward. Even if CMS makes good on its 2022 proposal to move some musculoskeletal procedures back to its inpatient-only list, total joint surgeries in ASCs will continue to thrive.
Keys for Cardiology Procedures in ASCs
More cardiac catheterization procedures are moving to ASCs. The new Quincy Medical Group Surgery Center is the first in Illinois to move in this direction. According to MedPAC, single-specialty cardiology ASCs have grown from 18 in 2017 to 88 in 2019. Granted, these numbers are not large and neither is the base, compared to some specialties. However, a 2018 Bain & Company Report expects cardiology procedures performed in ASCs to grow at a faster rate than other specialties through the mid-2020s. CMS catalyst behavior, state laws governing licensure and regulation, and relationships among healthcare stakeholders are all keys in cardiology ASCs’ development.
Healthcare Industry/Trends
Hospitals’ Shifting Care Strategies
Our national healthcare responses to Covid19 have pressed a number of trends forward more quickly than they would have moved otherwise. One of those trends is the decentralization of surgeries. That forces hospitals, ASCs, and large independent physician groups to shift aspects of their care and hospitals, at least for now, have the biggest adjustments to make. Patient flow has been disrupted at some hospitals to the degree that hospitals are making long-term decisions about what kinds of care they will continue to provide. Several are closing departments, clinics, primary care practices, and even certain surgical services.
Harried Healthcare Staff – Particularly in Hospitals
Another fact weighing heavily on healthcare now is the impact of the struggles of providing medical care throughout a long pandemic. Physicians and healthcare staff who have served so honorably for so long and beyond the call are experiencing burnout, an increase in more serious patient conditions, and significant bouts of depression and anger. Many have also experienced a reduction in income and staff. In addition, nursing shortages are growing across the country as demand has risen, both due to Covid care and to national demographics.
Healthcare Digital Transformation Watch
Where Are We with Telehealth?
Telehealth utilization dipped this winter and early spring but has since bounced back. See FAIR Health’s telehealth regional tracker for monthly data. Telehealth visits accounted for 32% of total outpatient visits during the height of the pandemic have now leveled out to around 15% of total visits – still multiples ahead of pre-pandemic levels. At issue for the future – telehealth regulations and reimbursement. Some experts believe that private payers may need to lead the charge on telehealth reimbursement rather than to wait for action from Medicare. Healthcare industry stakeholders are pressing House and Senate leaders to ensure that Medicare beneficiaries keep recently expanded telehealth coverage.
Legal
$1.2 Trillion Infrastructure Bill and Healthcare
From the office of Jon Sistare, JD, Attorney at Law
The biggest news out of Washington recently has been the passage of the $1.2 Trillion Infrastructure Bill. By its name, those in the healthcare field might not think it has any relevance to healthcare. But, a bill that large and with healthcare such a massive part of our economy, there has to be something in that bill that relates to healthcare.
Indeed there is! First, the legislation postpones the implementation of HHS OIG’s final rule titled, “Fraud and Abuse; Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees.” Among other provisions, the final rule amends a regulation to remove safe harbor protection for reductions in price in connection with the sale or purchase of prescription pharmaceutical products from manufacturers to plan sponsors under Medicare Part D, either directly or through pharmacy benefit managers (“PBMs”) acting under contract with them, unless law requires the reduction in price. These changes were initially set to take effect on January 1, 2022, but now, under this legislation, they will not be implemented until January 1, 2026.
Secondly, the legislation includes the “Make PPE in America Act,” which requires HHS to enter into long-term contracts with domestic suppliers and manufacturers for personal protective equipment (PPE). However, the legislation includes some exceptions for availability, as well as for compliance with international trade agreements. The purpose of the provision is to rebuild the domestic PPE supply chain by incentivizing domestic production of PPE, materials, and components.
Thirdly, the legislation sets aside $42.45 billion for the “Broadband Equity, Access, and Deployment Program.” The legislation also sets aside $2 billion for rural broadband improvements. One purpose of these provisions is to improve access to telehealth services for rural and underserved communities.
Finally, while earlier reports indicated that unspent funds from the COVID-19 Provider Relief Fund (PRF) to cover lost revenue attributable to COVID-19 would be rescinded, the PRF funds were untouched (despite many other COVID-19 relief funds being rescinded). In fact, two new bipartisan bills were introduced last Wednesday that would extend the deadline for providers to expend PRF funds until December 31, 2021, or until the end of the COVID-19 public health emergency, whichever comes later.
All of the above is good news for those in the healthcare field. Furthermore, in the budget framework legislation that just passed the Senate, there is even more to improve our healthcare industry. We’ll highlight that in future articles.
At a Glance
First Grads of Optum Care/UNLV Joint Residency Program
Optum Care Ventures into Ortho Residency
Walmart Files to Extend Healthcare Expansion
Plans to Increase Telehealth to 37 States
Adults Not Aware of Hospital Transparency Rules
Fewer than 10% Know about Rules to Help Cost Planning
CMS’ 2022 Updates to ASC Payment and Inpatient-Only List
60-Day Comment Period Ends September 17
Pentagon Requires US Troops to Get Covid Vaccine
Move Needs Full FDA-Approval or Presidential Sign-Off
Kroger and Lyft Team Up to Offer Rides to Vaccine Appointments
Rides Discounted to $12 per Trip
To subscribe or unsubscribe to ASCs in Motion, simply send an email request to levans@contegollc.com.
To inquire about Contego’s expert reimbursement solutions:
Call 855.505.8346 x1245 or Email info@contegollc.com
Contego Solutions, LLC
https://contegollc.com
https://www.linkedin.com/company/contego-solutions-llc/