Issue link: https://beckershealthcare.uberflip.com/i/1230114
14 ASC MANAGEMENT The outpatient push continues — 6 hospitals adapting to utilization changes By Angie Stewart S urgical advancements that facilitate low-cost, high-quality outpatient care have prompted insurers and provid- ers to reexamine where care is delivered. With the U.S. outpatient surgical procedure market expected to hit $144 billion by 2026 — up from $122 billion in 2018 — it's clear that a shi is taking place. In the first weeks of 2020, several develop- ments indicated as much. HCA Healthcare CEO and Director Samuel Hazen reported that 15 percent of the total joints done at HCA facilities are in the outpatient setting. Surgery Partners CEO Wayne DeVeydt outlined the value proposition of ASCs dur- ing the 38th Annual J.P. Morgan Healthcare Conference, explaining that Medicare pays less for the same procedures in outpatient settings versus inpatient. More tangibly, Blue Cross Blue Shield of Minnesota implemented a policy steering colonoscopy patients away from hospital outpatient departments and into ASCs. As more insurers look to adopt similar policies, several hospitals and health systems have reconfigured their services, oen increasing their focus on outpatient care. Here are six organizations taking action due to changing utilization: Buffalo, N.Y.-based Kaleida Health is put- ting a hospital tower up for sale in response to declining use. e hospital's inpatient admissions have fallen 33 percent since 2012. Its outpatient and inpatient surgery volumes have dropped 54 percent and 63 percent, respectively. As part of bankruptcy proceedings, Yakima, Wash.-based Astria Health will close Astria Regional Medical Center in Yakima and migrate services to its ambulatory care and outpatient locations. Philadelphia-based Holy Redeemer Health System opened its first outpatient care center in Philadelphia, an 11,000-square-foot center. Holy Redeemer operates six other outpatient care centers in the region. Lawrenceburg, Ind.-based Highpoint Health laid off 31 employees in late January amid significant financial challenges, includ- ing a drop in patient volume. In an interview with e Ohio County News, Highpoint President and CEO Michael Schwebler cited competition and a rising number of inpatient procedures moving to the outpatient setting as reasons for low patient admissions. WhidbeyHealth in Coupeville, Wash., is recruiting surgeons to increase its outpatient surgery volumes and revenue. e organiza- tion hopes to minimize losses stemming from declining inpatient stays. e University of Illinois Hospital & Health Sciences System in Chicago plans to build a $191 million outpatient center to fill a growing need for outpatient services. n Tenet-owned surgical hospital to pay $1.4M to settle False Claims Act allegations By Rachel Popa T enet Healthcare's Desert Regional Medical Center in Palm Springs, Calif., has agreed to pay $1.41 million to settle allegations it implanted unneces- sary cardiac monitors. The settlement resolves charges that the surgical hospi- tal allegedly charged Medicare between 2014 and 2017 for cardiac monitors when they weren't medically neces- sary, which violates the False Claims Act. "Invasive medical procedures, such as implanting heart monitors, are not without risk," said Timothy DeFranc- esca, special agent in charge for the office of inspector general of the U.S. Department of Health and Human Services. "Therefore, when these procedures are medi- cally unnecessary, as contended in this case, people in government health programs are put at needless peril, and taxpayers end up with the bill." Michael Grace, a former hospital employee, filed a whis- tleblower lawsuit under the False Claims Act. Through the settlement, Mr. Grace will receive $240,789. n Florida ASC buyer projects $18M profit in 1st year: 5 details By Laura Dyrda Praxsyn signed a letter of intent to purchase a Florida- based surgery center. Five key details: 1. Praxsyn plans to acquire Amelia Island Outpatient Sur- gery Center in Fernandina Beach, Fla. 2. The 9,000-square-foot ASC is part of a larger 29,000 square foot building, which Praxsyn will purchase. The remaining space will be used for medical offices. 3. The building's appraised value is $8 million. 4. A portion of the acquisition cost of the ASC will likely be syndicated to physicians working at the center to reduce acquisition debt. Praxsyn intends to remain the majority owner. 5. At its peak, the center could generate $7.5 million in gross revenue, and there is room for expansion. n