Becker's ASC Review

60 13th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine – Call (800) 417-2035 What Does 2015 Hold for Eye Surgeons & Centers? By Anuja Vaidya T hree eye surgeons discuss the biggest opportunities for ophthalmol- ogists and ophthalmology-driven eye centers in 2015, challenges fac- ing the industry and the latest regulatory changes. Question: What are some of the most exciting opportunities for eye center surgeon owners in 2015? Shane Kim, MD, EyeHealth Northwest (Portland, Ore.): In short, the baby boomers are coming! For the next 20 years, over 3 million baby boomers each year will be eligible for entry into the Medicare sys- tem. That along with the over 7 million people who obtained insurance through the Medicaid system under ObamaCare means we will have no shortage of patients. Furthermore, under the Balanced Budget Act of 1997, the number of doctors trained in U.S. resi- dency programs was capped. As a result of the confluence of all these fac- tors, many eye doctors in the country will see their practices growing and the number of patients seeking out cataract surgery will only increase each year. I think as owners of efficiently-run eye surgical centers, we will be well- positioned to provide access to excellent eye surgery at a much lower cost than care in a traditional hospital setting. Donald Keller, MD, Boulder (Colo.) Eye Sur- geons: The most exciting opportunities for oph- thalmologists invested in surgery centers is the ex- plosion of technology at our disposal. We have had premium lenses for several years, but now we are moving into a new realm of laser-assisted cataract surgery with femtosecond technology instruments to plan and deliver more precise surgical outcomes. This technology is finally financially feasible for many small-to moderate-sized facilities. The cost of these instruments has been significantly reduced over the last several years and the market has demanded the companies producing them be more flex- ible in their approach to physician location and utilization. Michel Gelinas, MD, Eye Care & Eye Wear Associates (Woodruff, Wis.): I think many of the new technologies are exciting. For example, use of the femtosecond technology in laser-assisted cataract surgery and toric and mul- tifocal lens implants. Lately, I've also been excited about the use of an injec- tion of antibiotic and steroids intravitreally so that patients don't have to use drops after surgery. Q: What are some of the most pressing issues or challenges fac- ing eye surgeons in the coming year? SK: The biggest challenge for all doctors is determining how to deliver high- quality care at a lower cost to the health system. For years, ambulatory surgi- cal centers have been holding down healthcare costs for outpatient surgeries while delivering top-notch care. On average ASC reimbursement rates are 58 percent of what a hospital outpatient department receives for the same procedure. Within the Medicare system alone, ASCs save taxpayers $2.6 bil- lion a year. The challenge for eye surgeons is to continue to educate insurance companies, regulatory bodies and the public about the cost saving benefits of ASCs. DK: Ophthalmologists and the ASCs they work with need to develop cre- ative and cooperative approaches to new technologies, lowering the cost for the centers, physicians and patients. In the past, ophthalmologists have had a reputation for being very competitive. With the expense of these newer technologies, a cooperative approach will be necessary for long-term success. MG: Insurance reimbursement and insurance contracting are significant po- tential headaches. We have to continue to work locally and nationally so that everyone can understand the benefits of eye surgery and what we are accom- plishing in the field. We need to talk to leaders and politicians in Washington about the benefits. Q: What regulatory changes will affect eye surgeons and centers the most in the coming year? SK: On Oct. 31, CMS issued the calendar year 2015 Hospital Outpatient Pro- spective Payment System and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates final rule. For ophthalmology, this is ex- pected to produce a 1 percent decrease in reimbursement for cataract surgery codes 66984 and 66982. However, there is a 3 percent increase in reimburse- ment for after cataract surgery laser code 66821. In 2015, Medicare-certified facilities will be required to report data on 10 quality measures as opposed to five in 2014, largely focused on patient safety. However, as a result of advocacy efforts by multiple ophthalmology groups, ASC quality measure 11, "Cataracts — Improvement in Patient's Visual Func- tion Within 90 Days Following Cataract Surgery," was changed from required to voluntary reporting. It is largely held that the responsibility for gathering this quality data should be with our physician practices and not the ASC.

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