Becker's ASC Review

13 ASC Management I ts official: The Republican Party is in control of Congress. While predic- tions that the GOP had a chance at gaining enough seats in the Senate on Nov. 4 to take Congress were common, the party proved even more successful, sweeping more than the 7 seats they needed to take control and even forcing a runoff election in Louisiana. Now that the GOP controls the legislative branch, what does its strong posi- tion mean for healthcare? Lately, there has been plenty of buzz about whether the party will challenge the Patient Protection and Affordable Care Act directly. While this was a pop- ular strategy upon which Republican candidates ran for Senate, it's fallen out of favor. It seems unlikely Republican control of Congress will mean a repeal, either full or partial, of the PPACA. However, the PPACA remains unpopular with the public. In the context of the midterm elections, the economy ranked far above the healthcare law in importance to voters — up to three times as mentioned. The PPACA may well have already reached the peak of its popularity last winter. The law isn't broad-based entitlement program like Medicare, and it caters to a specific segment of the U.S. population. So, the majority of the PPACA's potential supporters may already be on the bandwagon. Rather, the discussion about the healthcare law and healthcare in general will likely shift from a Democratic one one — where expanding policy is key — to a Republican one — in which discussions of spending cuts are almost guaranteed. Use of budgetary tools to affect legislative change is far easier for the party than being vocal, especially given the current political climate. Given the Democratic president, it's unlikely any large overhaul of any health policy would be especially successful, and it would burden the GOP with the added problem of bad press. Much more important to the future of healthcare than the 2014 midterms will be the 2016 elections, when the presidency will be up for grabs and full alignment of the executive and legislative branches of government may be a possibility. Strategically speaking, it could benefit both parties to lay low in the interim, changing little and waiting for their opponent to make a mistake. This doesn't mean no change is possible. In the ambulatory surgery center in- dustry, CMS released slightly increased payments for fiscal year 2015 already. But, it seems likely that drastic change is out of the question between now and 2016. Certainly, appropriations will afford the opportunity for minor altera- tions in healthcare law, healthcare payments and the country's general stance toward domestic health policy; however, major overhauls seem unlikely. n How Will the Republican Sweep Affect Healthcare? By Ellie Rizzo info@physiciancontrol.com or call 404.920.4950 www.physiciancontrol.com In partnering with IMS, a leading physician is designated as the surgery center's medical director and is involved with decision making for the organization; a rare concept with corporate partners in today's ASC environment. With an aggressive growth pl plan and robust capital reserves, IMS is focused on ASCs with growth potential regardless of size or location. Our experience allows us to finalize transactions quickly, so you can focus on what matters...your patients. Let us show you how partnering with IMS can enhance your center's success through ph physician control. Interventional Management Services Less Red Tape. More Time For What Matters. IMS specializes in development and management solutions for all types of ASCs. Our emphasis on physician control and our no-nonsense approach set us apart from traditional ASC management companies. ASC Medicare Payments to Rise 1.4% in 2015 By Carrie Pallardy T he Centers for Medicare and Medicaid Services has released its final 2015 ASC payment rule, according to an Ambulatory Sur- gery Center Association of Illinois report. Here are five things to know about the final rule. 1. ASCs payment rates will rise 1.4 percent in 2015. The bump in pay- ment is based on a 1.9 percent expected rate of inflation minus a 0.5 percent productivity adjustment, as required by the Patient Protection and Affordable Care Act. 2. The payment increase is 0.2 percent higher than the 1.2 percent update included in the Medicare proposed rule. The proposed increase was based on projected inflation of 1.7 percent minus the 0.5 percent adjustment. 3. Previously, CMS defined device-intensive procedures as those in which the device cost accounted for more than 50 percent of the total procedure cost. In the 2015 final rule, CMS updated ASC device-inten- sive procedures as those in which the device cost accounts for more than 40 percent of the total procedure cost. At the 50 percent threshold, there were 163 procedures in an ambulatory payment classification that were not performed in ASCs due to lack of adequate reimbursement, accord- ing to the report. Now at the 40 percent threshold, there are 48 codes that are still prohibitive due to device costs. 4. CMS also made ASC-11: Cataracts: Improvements in Patient's Visual Function within 90 Days Following Cataract Surgery a voluntary mea- sure for the ASC Quality Reporting Program. The final rule also final- ized the proposed quality measure ASC-12: Facility Seven-Day Risk- Standardized Hospital Visit Rate After Outpatient Colonoscopy. 5. The final deadline, as mandated by the final rule, for ASC-8: Influ- enza Vaccination Coverage Among healthcare Personnel is May 15, 2015. The quality measure must be reported through the National Healthcare Safety Network. n

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