Becker's ASC Review

90 1. New York — 37 percent 2. Georgia — 27 percent 3. Kentucky — 22 percent 4. Kansas — 21 percent 5. Indiana — 19 percent 6. South Carolina — 17 percent 7. Minnesota — 16 percent 8. Pennsylvania — 15 percent 9. Washington — 12 percent 10. Illinois — 11 percent 11. Maryland — 10 percent 12. New Mexico — 10 percent 13. Virginia — 9 percent 14. Delaware — 8 percent 15. Alabama — 8 percent 6 35. e five worst states in which to practice are, according to a Medscape's Best and Worst Places to Practice: • New York • Rhode Island • Maryland • Massachusetts • Connecticut 36. CMS released the 2016 proposed payment rule for ASCs and HOPDs on July 1, 2015. ASCs could see an effective update of 1.1 percent and HOPDs would see an effective update of 1.9 percent. e inflation update factor is substantially different for ASCs and hospitals. While ASCs could have infla- tion update factor of 1.7 percent, HOPDs could have an inflation update fac- tor of 2.7 percent if the proposed rule is finalized as draed. 1 37. Single-specialty ASCs are not as highly valued by operators as multispeci- ality ASCs. When purchasing a controlling interest in a single-specialty ASC, 65 percent of ASC companies reported prevailing valuation multiples of 6.0 to 7.9 times EBITDA with 35 percent reporting lower valuation multiples ranging from 4.0 to 5.9 EBITDA. 11 38. When purchasing a controlling interest in a multispeciality ASC, 78 per- cent of ASC companies reported prevailing valuation multiples of 7.0 to 8.0 times EBITDA while 23 percent reported lower valuation multiples ranging from 5.0 to 6.9 times EBITDA. 11 39. ASC leaders report high levels of satisfaction, with an average job satisfac- tion rating of 4.2 out of a 5 point scale, according to a Provista report. One- third are "very satisfied" and none reported not being satisfied. 13 40. Sixteen percent of physicians are very engaged in supply cost manage- ment and 39 percent reported being engaged. Only 6 percent reported not being engaged at all. 13 41. McKenzie-Willamette Center fired Kristian Ferry, MD, aer he per- formed procedures at an ambulatory surgery center not owned by the hos- pital. Dr. Ferry is suing the hospital for breach of contract, interference with his medical practice, wrongful termination and defamation. e lawsuit is seeking $6 million in economic damages plus an additional $3.8 million in noneconomic damages for emotional distress and damage to Dr. Ferry's reputation. 42. New Hampshire Rep. David Hess (R) proposed state legislation to place a tax on ASCs. e provision in the Medicaid Enhancement Tax would low- er the tax rate by 10 percent while widening the tax on hospitals to include ASCs and ambulance services in New Hampshire. 43. ASCs must have an inspection conducted by a state official or a represen- tative of an organization authorized by the government to ensure ASCs are meeting regulations. Accreditation bodies for ASCs include the American Association for Accreditation of Ambulatory Surgery Facilities, the Accredi- tation Association for Ambulatory Health Care, Healthcare Facilities Ac- creditation Program and the Joint Commission. 1 44. Yorkville Endoscopy in New York lost government and industry accredi- tation in January 2015 following comedian Joan Rivers' death at the center. Joan Rivers suffered a heart attack during a vocal chord procedure on Aug. 28, 2014. She died a few days later. Two physicians, Lawrence Cohen, MD, and Gwen Korovin, MD, are under scrutiny for the procedures on Ms. Rivers, including a previously unplanned biopsy. 45. California has 694 ASCs, making it the leading state in terms of concen- tration of ASCs. It is followed by Florida with 387 ASCs and then Texas with 347 ASCs. 46. Although surgeons face payer issues, 94 percent of ASC management companies reported orthopedic spine was a desirable specialty. 47. Approximately 68 percent of ASC management companies reported hav- ing equity ownership in all freestanding entities they managed. 11 48. Approximately 25 percent of ASC management companies reported hav- ing 11 to 30 ASCs under ownership. An additional 30 percent reported hav- ing 31 or more ASCs under ownership. 11 49. Ninety percent of ASC management companies reported they prefer be- tween six and 15 physician owners for a single-specialty ASC. Eighty-nine percent of respondents prefer between 11 and 20 physician owners for a mul- tispecialty ASC. 11 50. CMS announced a one-year grace period for claims with ICD-10 diag- nostics codes that go into effect Oct. 1. is will be the third delay for ICD-10 implementation, which was initially set for October 1, 2013. 12 n Footnotes 1 Ambulatory Surgery Center Association. 2 Medicare Payment Advisory Commission 2015 data. 3 VMG Health's 2011 Intellimaker ASC Benchmarking Study. 4 Billians Healthdata. 5 Law 360. 6 RemitData. 7 Fortune. 8 Chicago Business. 9 Surgical Care Affiliates. 10 Ambulatory Surgery Center Management and Development. 11 HealthCare Appraisers data. 12 Centers for Medicare & Medicaid Services report. 13 2011 Provista Report of ASC Survey Findings. 14 Quality Reporting Center. 15 Medscape's Best and Worst Places to Practice: 2015.

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