Becker's ASC Review

18 ASC MANAGEMENT US Court of Appeals upholds Iowa certificate-of-need law By Eric Oliver T he U.S. Court of Appeals for the 8th Circuit ruled Iowa's certificate-of-need law did not violate the 14th Amend- ment, upholding a lower court's opinion, Jurist reports. What you should know: 1. Cedar Rapids, Iowa-based Fox Eye Laser & Cosmetic Institute sued after being denied a CON to perform outpatient surgery. The eye practice claimed the denial violated the 14th Amend- ment on the grounds that hospitals could object to the CON and infringe on the eye center's personal business. 2. The court pointed to the fact that hospitals need CONs as well. 3. In addition to the ruling, the court supported Iowa's right to limit the number of CONs it awards to outpatient surgery facili- ties in an effort to protect full-service hospitals especially in rural areas. That surgery centers endanger the economic viability of hospitals is a commonly refuted argument, according to the conservative-leaning Center of the American Experiement. 4. Iowa's certificate-of-need system is unique because it allows a CON-holder the rights to expand in any way without a new certificate, as long as the project is under $1.5 million in a single year. n COVID-19 updates for anesthesia practices — Volumes, funding & more By Angie Stewart S ix COVID-19 updates for anesthesia practices from Anes- thesia Business Consultants: 1. Volumes and collections. Many ASCs were closed in March due to COVID-19, causing anesthesia groups to see sharp drops in surgical volumes. As a result, practices can anticipate collections to be down in April and May, with a more significant drop-off in June or July. Fortunately, since many surgery centers are surgeon-owned, there is a strong financial incentive to resume cases. "By May, things should start returning to normal," said ABC Pres- ident and CEO Tony Mira. "While a number of practices cannot withstand such a hiatus, those that can will ultimately recover." 2. Federal funding. Anesthesia groups that have attested to the first round of relief payments from HHS can apply for the second $20 billion general distribution fund. A company officer or certi- fied public accountant must complete the application process, which will require access to the practice's latest federal tax return. 3. Medicare payments. Effective April 26, CMS suspended its Advance Payment Program to Part B suppliers and began reevalu- ating amounts paid under the Accelerated Payment Program. e agency had already paid over $100 billion to healthcare providers and suppliers through the programs. 4. Patient outcomes. rough an artificial intelligence platform called F1RSTAI, ABC evaluated how patient outcomes relate to COVID-19 infections. According to a predictive analysis using data from 40 ABC clients, the top four indicators of mortality in COVID-19 patients were having a preexisting respiratory disease, being immunocompromised, living with a preexisting heart con- dition, and having diabetes. Length of stay in the ICU wasn't as strongly tied to patient outcomes as originally expected. 5. New roles for anesthesia clinicians. Anesthesia provid- ers are performing more emergency intubations during the COVID-19 crisis, according to a survey of 148 ABC clients. For nearly 1 in 5 respondents, intubations are taking longer than usual because of personal protective equipment and sterile disrob- ing protocols. Half of respondents said they were being asked to cover ICU services, including vent management or critical care, but only about 30 percent said they were offered payment for ICU coverage. 6. Payer support. Blue Shield of California has made four programs available to qualifying network providers, including hospitals, medical groups, independent physician associations and independent physicians. Blue Shield is providing advance payments, offering loan guarantees, assuming member liability obligations and transitioning certain commercial providers to value-based contracts or risk-sharing capitation contracts. n Surgery Partners reports fraction of typical volumes; negative earnings projected: 4 things to know By Angie Stewart M any ASCs operated by Brentwood, Tenn.-based Surgery Partners are operating at less than one-fifth of typical volumes, Nashville Post reports. Four things to know: 1. Surgery Partners, which operates 111 ASCs and 16 hospitals, said many of its facilities were open during the pandemic. Its hospitals are operating at about 20 to 40 percent of normal levels. 2. In an update to investors, Executive Chairman Wayne DeVeydt said Surgery Partners isn't able to forecast how many suspended procedures will actually be carried out at its facilities once elective case restrictions are lifted. 3. Surgery Partners has furloughed some workers and converted some salaried staff to hourly rates, which helped it slash quarterly operating costs — which are typically $380 million — by roughly 50 percent. It closed out March with $185 million in cash and cash equivalents. 4. Majority owned by Bain Capital, Surgery Partners has had four U.S. leveraged loans during the pandemic. n

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