Issue link: https://beckershealthcare.uberflip.com/i/827052
50 CODING & BILLING Here's what you should note about the models: e "Comprehensive Colonoscopy Advanced APM" is a bundled pay- ment model that encourages providers to collaborate and coordinate care across settings to manage patients who need colonoscopies for colorectal cancer screening, diagnosis and surveillance. e "Project Sonar Advanced APM" is a care management program designed to improve chronic disease management. Gastroenterolo- gists have used the program thus far to manage Crohn's disease. e model allows for decreased cost of care, earlier identification of high- risk patients, the proper channeling of patients and heightened patient engagement. e Physician-Focused Payment Model Technical Advi- sory Committee voted to recommend Project Sonar to the Secretary of HHS in April. Since IGG first rolled out the program in 2013, Project Sonar has em- ployed evidence-based medicine coordinated with proactive patient engagement to improve outcomes among sufferers of Crohn's Disease. As part of their treatment plan, patients are: • Assessed with biopsychosocial measures • Enrolled into a web-based communication program • Seen on a monthly basis; with frequency intensified as needed Providers use a team-based approach through the model, while ad- ministrators analyze clinical and financial data, revising care manage- ment algorithms, as needed. Project Sonar allows for providers to "intervene before patients even realize they need care." n Judge Awards Aetna $51.4M in Out-of-Network Billing Case Against Surgical Hospital By Laura Dyrda U .S. District Judge Lynn Hughes awarded Aet- na $51.4 million in a seven-year court battle against Humble (Texas) Surgical Hospital, ac- cording to Chron. The decision was made before the case was brought to a jury. In 2012, Aetna sued Humble Surgical Hospital for charging 10-times market rates on out-of-network pro- cedures. The insurance company contended Humble Surgical Hospital offered discounts to out-of-network patients so their fees were similar to in-network pa- tients, but billed Aetna higher rates as an out-of-net- work provider. The hospital's lawyer said Humble Surgical plans to file an appeal. Humble Surgical Hospital was involved in similar cases with Cigna, in which the court ruled in Humble Surgical's favor. n Assisting physician-owners in hundreds of transactions for over 30 years | www.ASCs-Inc.com Majority and Minority Interest Sales | Growth Strategies | Real Estate Sales | ASC and Practice Expertise "Most physicians will sell their ASC once, which puts them at a big disadvantage when selling to buyers who have done many transactions and have teams of experienced negotiators whose job is to get the best deal for the buyer. ASCs Inc.'s experience in advising the sellers on hundreds of transactions ensures that the best interests of our clients are represented throughout this complex process and that our clients receive maximum value for their ASC assets." Looking for a strategic partner or for a growth strategy? Have you been approached about selling your center? Are you thinking about selling your ASC real estate? In any of these scenarios the best thing you can do is to call ASCs Inc. first! Contact us today! 760-751-0250 | info@ASCs-Inc.com — Jon Vick, President Considering Selling an Interest in Your ASC?