8
ASC
MANAGEMENT
CMS final rule includes definition change to add 131
more device-intensive procedures: 5 things to know
By Laura Dyrda
C
MS made several updates to ASC
payments in the 2019 final payment
rule, issued Nov. 2. One of the key
changes for ASCs is broadening the defini-
tion of device-intensive procedures, adding
around 131 procedures for Medicare benefi-
ciaries in the ASC setting.
Here are five things to know:
1. CMS updated the definition of device-
intensive procedures from procedures where
the device is 40 percent of the overall cost to 30
percent of the overall cost for the procedure in
the hospital outpatient department.
2. e lowered threshold is expected to
make it economically possible for ASCs
to be able to provide 131 device-intensive
procedures to Medicare beneficiaries for the
first time. "[is is] a policy change we have
been advocating for over the past several
years to encourage migration of these
procedures into ASCs," said ASCA CEO
William Prentice in a Q&A posted on the
organization's website.
3. e new definition of device-intensive
increases the number of device-intensive
procedures ASCs can afford to provide to
Medicare beneficiaries from 154 to 285
procedures for 2019.
4. Among the newly approved cases are
several cardiac procedures. e payment
rule also revises the definition of "surgery"
for ASC payments to include "surgery-like"
procedures, which adds 12 cardiac catheter-
ization procedures to the ASC list as well.
5. For device-intensive procedures, the total
cost of the device is included in the reim-
bursement rate for ASCs.n
Vascular Institute signs
5-year lease to share ASC with
Sacramento Heart — 5 insights
By Angie Stewart
S
acramento-based Vascular Institute of Northern
California owners signed a five-year lease for a
3,834-square-foot medical space, Sacramento
Business Journal reported.
Here are five insights:
1. The Vascular Institute, a newly established medical
group, will occupy part of a 71,200-square-foot block of
offices in Sacramento owned by the Sacramento Heart
and Vascular Center.
2. Sacramento Heart and the Vascular Institute physi-
cians will both perform surgeries out of an ASC Sacra-
mento Heart built on the building's first floor within the
last year.
3. Vascular Institute physicians will perform minor pro-
cedures in its offices and move patients downstairs for
vascular surgeries. It will use the ASC twice a week.
4. Vascular Institute specializes in treating peripheral
artery disease, varicose veins and spider veins.
5. Sacramento Heart's main offices are located on the
site, which also houses several Sacramento-based UC
Davis Medical Group offices for family and internal
medicine. n
The 4 ways ASCs can fail — How
to avoid these critical mistakes
By Rachel Popa
W
hile the shift to outpatient surgery is ongoing,
ASCs can still fail if they're not managed properly,
according to Regent Revenue Cycle Management.
The company shared four ways ASCs can fail and how
administrators can plan for success.
Here are the key takeaways:
1. Contracts - If ASC administrators don't properly man-
age their contracts, negotiations with payers can be more
difficult. Integrating CMS changes into multi-year contracts
and updated procedures are two ways administrators can
negotiate contracts more efficiently.
2. Rising costs - Losing money through unprofitable cases
and poor supply chain management are two challenges
that can inhibit an ASC's success. Investing in electronic
inventory management systems is one way ASC administra-
tors can keep better track of costs.
3. Lack of high reimbursement cases - Adding profitable
procedures such as total joint replacements and outpatient
spine surgeries can help an ASC raise revenues.
4. Revenue cycle management - Not properly managing
an ASC's revenue cycle can affect the center's profitability.
Optimizing reimbursement and understanding Medicare
and Medicaid payment bundling can help ASC administra-
tors take control of their center's reimbursements. n
