Becker's ASC Review

21 Thought Leadership However, in order for the measures to be useful, they need to be appropriate and specific and not just an exercise in data collection. We need to be able to act on the data. Our focus over the last couple of years has been toward patient-reported outcomes: Do we see better outcomes for patients using one implant over another? Do patients undergoing robotic proce- dures do better in the long term? Can we reduce or eliminate the use of narcotics in surgery and postoperatively, while ensur- ing patients can recover in comfort and be discharged home? e quality reporting measures currently lack imagination and are of limited use in driving real improve- ments in quality and outcomes. Curtis Collins. COO of Palmetto Surgery Center (Columbia, S.C.): "F." CMS caved in to big hospital systems in regards to: 1. e orthopedic procedures that could be safely performed at surgery centers with a significant taxpayer savings. 2. e mandate for all team members to be vaccinated at CMS-accredited facilities. Trudy Wiig, RN. Administrator and Managing Officer of Kerlan-Jobe Surgery Center (Los Angeles): e single thing that CMS waffled and fell on, in deference to their alleged mission of saving money, was giving in to the hospital lobbyists related to the types of procedures that can be performed safely in an ASC setting. Hospitals continue to hang on to the final vestiges of surgical procedures that should be performed, for most, in an ASC setting. Taxpayers, CMS and upcoming CMS recipients cry foul. ey are or will be adversely affected by laborious admis- sion processes, subjected to excessive hospital-acquired infection rates, minimal registered nurse care post-procedure and greater dollars spent per recipient, among a few factors that differentiate ambulatory surgical settings. ese are some reasons why ASC patient satisfaction rates far exceed the hospital rate. ASCs do ambulatory/outpatient surgery or procedures best, more efficiently and at a lower cost than hospitals or hos- pital outpatient departments, who receive three times the reimbursement of ASCs for the same procedure. If CMS is going to ca- ter to hospitals on the strongholds, fine — let there be parity for the same procedure regardless of the setting, be it the hospital outpatient department or the ASC. n CMS moves boost value- based care in ASCs By Patsy Newitt Both payers and CMS have noticed op- portunities in value-based care to lower costs and strengthen patient care. Peter Young, president of HealthCare Strategic Issues in Fort Myers, Fla., spoke with Becker's about how CMS and artificial intelligence are the two biggest opportunities for growth for ASCs. Editor's note: This answer was edited lightly for brevity and clarity. Question: Where are ASCs biggest opportunities for growth in 2022? Peter Young: The two most significant opportunities in the ASC sector fall into two different arenas — operational structure and technology or artificial intelligence/smart tools. The first, less recognized, is the CMS approval of the value-based enterprises, allow- ing for broader business relationships between physicians, vendor enablers and continuum vendors. CMS also relaxed Stark Laws, and this contributes additional flexibility to value-based enterprises and physician relationships in general. New opportunities in entity structure are now possible. The continuing evolution of artificial in- telligence/smart tools for orthopedics, spine and now cardiology via CMS- approved procedure codes will hasten the migration from hospitals to ASC and, in the cardiology sector, to office locations as well. The continuing integration of evolving AI/smart tools, starting with advanced procedure navigation to actual pro- cedure, will contribute to the pace of migration to ASCs. n How ASCs can win in value-based programs By Marcus Robertson S hannon Yarrow, senior vice president of managed care at Brentwood, Tenn.- based Surgery Partners, joined "Becker's ASC Review Podcast" to talk about ASCs capitalizing on value-based payment programs. Note: This is an edited excerpt. Question: How could surgery centers win in value-based programs, particularly for service lines like total joints that are in such high demand, when there's lots of money to be saved by moving into surgery centers? Shannon Yarrow: What we're seeing is that if we can engage with accountable care organizations and show them that we can provide the high-quality, lower-cost setting, that is a true incentive. They are at risk for a certain budget of dollars, and if they spend less than the budget, then they get to share in the savings, usually with the health plan. So we can be a really good cost-effective alternative, especial- ly in those high-cost areas like total joints or spine procedures, where the differen- tial between the cost at a hospital and the cost at an ASC can be pretty significant. As ASCs, we want to engage with those types of organizations that are taking risk in terms of bundled payments. We've seen some growth in this space. ... We're starting to see a lot of employer interest for the self-funded payers in the bundled payment arrangement. And that does put a little bit of risk on ASCs and physicians to make sure that they are giving high-quality care and selecting the appropriate patients for those bundles. But I do think that also leads to opportunities and more growth for volume opportunities, and so saving the health system money. n

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