ASC Archives - NextServices

22 Sep 2016

Now’s the time to prepare for 2017 quality reporting for ASCs

Written By Vikant Shah | NextServices

In 2012, the Centers for Medicare and Medicaid (CMS) proposed a new “pay-for-reporting” program called ASCQR. Under ASCQR, ambulatory surgery centers report on specific quality metrics in return for a full annual update to their annual payment rate, beginning with year 2014.

Since its implementation, the number of reporting measures have been steadily gone up from 5 in 2014 to 12 in 2017. As the measures indicate, CMS wants to track episodes such as burns, falls, performing wrong procedures or treating patients, hospital transfers, follow-up interval for colonoscopy and so on. CMS intends to continue ASCQR well into the future.

ASCs who have not been able to collect this information in 2016 will do well by preparing now to start collecting for 2017. You will have the first 8 months (Jan through August) of 2018 to report for the same. ASCs that meet program requirements would receive full payment update for year 2019; ASCs that do not participate or fail to meet these requirements may receive a two percent reduction of their payment update. For next year, first five measures (from ASC-1 to ASC-5) must be reported by applying G-codes during claim submissions. The next 6 measures (from ASC-6 to ASC-11) must be reported using online tools (QualityNet’s secure portal and NHSN, a surveillance system operated by CDC). Watch out for posting of the final rule and any changes to next year’s program.

Study the measures and identify how they relate to your workflow (for e.g.. the flu vaccination season). Create quality champions within your team who will work on capturing longterm measures such as colonoscopy interval for patients with history of adenomatous polyps – avoidance of inappropriate use. If you haven’t already, register your ASC in QualityNet’s portal and NHSN (links below). Ensure your billing team is aware of the G-codes that require to be submitted (available in the ASCQR checklist below). Work with your EHR vendor to test and check if you can easily pull up the data you would need.

Do not consider ASCQR as yet another compliance requirement. Patients will soon be able to search Quality Registries and know the kinds of problems your ASC would have reported on. ASCs with higher quality will have an edge over hospitals and surgery centers who fare poorly in quality programs.

Resources:

1) ASCQR Program Reference Checklist

2) ASC Quality Collaboration Report – 2nd Quarter 2016

3) QualityNet Secure Portal for submission of Measures ASC-6,7,9,10,11

4) National Healthcare Safety Network (NHSN) for submission of Measure ASC-8

16 Apr 2016

Business 0 comment

Four Ways to Get Your ASC Online

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As per the United States Census Bureau, 78.9% of all households in the country owned a personal computer at home in 2012. Of which, 74.8% actively used internet everyday. The percentage was just 18% in 1997. From news to products, we turn to internet for everything. The landscape is not very different with your patients. Before scheduling that visit at your center, patients look for the licensing information, board certifications, the specialties a particular doctor caters to, her affiliations with hospitals and medical communities, years in practice and patient reviews.

Internet has the potential to attract new patients and build trust amongst existing patients. Hence, it is extremely important for doctors, centers and administrators to build a strong web presence. The idea should be to make it easier for the patients to find you.

Here are four recommendations that can help you build a solid online presence foundation.

1. Build a website.
A website is the single most important digital extension of you/your center. Build a simple yet resource worthy website that explains who you are, what you do. Choose an appropriate website name (e.g. www.nameofyourcenter.com). To determine the website that is best suited for your business, think from your patients’ point of view. Question yourself, if you were the patient, what kind of information you would be interested in while visiting a center’s website. Clearly explain the types of services you provide, the insurances you accept, have downloadable patient resources (forms, educational material), physician/s profile and contact information. You can also integrate payment gateways on your website, making it easier for patients to pay co-pays and past balances. Giving an option to schedule an appointment online also increases patient engagement online and save time for front desk.

2. Be Social.
Consider building your presence on social media channels- Facebook, Twitter, Google+, YouTube, etc. According tostatistics, Facebook had over 1B active users in January 2014. Twitter and Google+ attracts around 232M and 300M active users. These are big numbers. People are spending a significant amount of time on social media. This population also includes your patients. Many business are actively using social media to attract new customers and build relationships. Consider signing up for Google Local to attract patients within your locality. When your practice is omnipresent over the web, your chances of getting found increases.

3. Be Mobile.
Smartphones and mobile tablets are replacing traditional computers to become the go-to device for accessing internet. Most users carry their mobile device wherever they go. But the mobile experience is significantly different from a PC experience. Your entire digital presence has to be optimized for mobile devices. For websites, use responsive design (this type of design optimizes your website for screens of all sizes automatically) or use a separate mobile website. Mobile ready websites should load quickly and provide the same robustness as their web counterparts.

4. Grow patient engagement.
Digital mediums if used smartly can serve as excellent platforms for increasing patient engagement. Integrate a patient portal with your website or EHR. Patients can just go to the website and review/update their medical information. For all scheduled visits, send registration forms as weblinks which patients can open on mobile or PC and fill prior to the visit. Encourage patient recommendations on physician forums such as vitals.com andhealthgrades.com. This will establish your center as a trustworthy and experienced source of healthcare service enabler. Publish the new procedures the center has started, the new insurances accepted on your website and push it through social media. Send health related weekly newsletters to patients to further drive the engagement.

Digital and social platforms, if maintained actively, can go a long way in getting new patients. It is not a build once and forget concept. Build a consistent experience throughout- your social media accounts should have some essential elements like color, images, similar to those on your website. This makes it easier for patients to relate. To get the most, make a point to update your channels regularly. Consider writing blogs, posting videos and initiating conversations with patients and peers on digital channels. It takes time to create digital presence so “Keep Calm and Carry On”.

16 Apr 2016

EHR, Industry Updates 0 comment

10 Global trends impacting medical care and what ASCs can do about it

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1) 90% of world’s data was generated in the last 2+ years. Vast portions of future data will constitute medical data generated through imaging studies, macro (lab tests, EHR, vitals, activity, diet etc.) and micro (genomic, microbiome, proteomic, other biomarkers) data. Additionally, medical knowledge is doubling every five years.

2) Whenever a field becomes more digital, it makes physical co-location redundant – examples, Amazon Kindle, ATMs, digital music, movies, phones and so on. Other high risk industries (e.g. flying a plane) rely largely on data algorithms with people controlling them.

3) DNA testing has dropped to sub $1,000 levels. 23andMe sequences a third of the genome for $100 (though they have stopped offering health related genetic reports after the FDA sent them a letter). It is expected that DNA testing will drop to pennies and doctors will routinely prescribe it. Separately, 1 million gene expression data sets are available as publicly accessible repositories.

4) Every 50 years, there’s a revolutionary change in healthcare – germ theory to advances in medication. It is expected that the biggest change now is that medicine will become a data science.

5) Several medical devices are increasingly Internet-enabled – e.g. GE’s V-scan ‘shows’ the heart instead of a stethoscope, Scanadu’s upcoming Scout measures a variety of vital signs remotely.

6) Autonomous vehicles (drones) are expected to deliver drugs and other goods remotely (see Matternet). It’s possible to build a basic quadcopter with a camera for $100-200.

7) Patients are increasingly quantifying themselves and comparing their data with others. Example Crohnology is a social network for Crohn’s Disease patients.

8) Artificial Intelligence is becoming a reality. IBM’s Watson has been training itself at Kettering Cancer Institute. IBM has made Watson available as an API that can be used by other applications. AI-based Google car (I sat in the first version in 2012) actually works quite well!

9) Most patients will have access to an Internet-enabled smart phone or tablet device and it’ll connect from everywhere. Patients will possibly even ‘wear’ a computing device.

10) Most doctors are performing some form of data-enabled, evidence-based medicine (e.g. boom in lab tests) instead of practicing on gut-feel.

Questions to consider for ambulatory surgery centers

1) Could ambulatory surgery centers expand the ownership of the medical problem from episodic care to the source of the medical problem? For e.g. ASCs focusing on screening for colon cancer can go upstream and identify why its patients are getting colon cancer.

2) Through the aid of EHR data and virtual care, can consults pre-and-post surgery be done remotely? Could new patients be screened virtually, thereby expanding outreach by 10x or more? Outside of the insurance reimbursement model, are there other ways to monetize this? (See American Well that partners with insurances).

3) What would an ASC’s impact on its area of care be if it were to collect and document data from its expanded virtual care model?

4) What would an ongoing multi-variant analysis from different sources with abnormalities reveal for the ASC’s patient population?

5) What role do bio/ genetic markers play in the ASC’s medical area of question? Example, for eye care.

6) Is there a correlation between location and the types of patients seen at the surgery center?

7) What insights could an ASC gain if a large portion of its patients were connected to each other online?

8) What if the EHR was implemented for delivery of healthcare itself in the future and not just as a means of digital storage and quality control?

By Praveen Suthrum, President & Co-Founder, NextServices.

09 Apr 2016

Industry Updates 0 comment

Top 10 surgical services at Ambulatory Surgery Centers (ASCs)

blog_top10surgicalservices

According this article, most frequently reimbursed services in an ambulatory surgery center (ASC) setting are below.

All belong to three specialties: ophthalmology, gastroenterology and orthopedics.

Cataract surgery with IOL insert, 1 stage: 17 percent (ophthalmology)
Upper GI endoscopy, biopsy: 8 percent (gastroenterology)
Colonoscopy and biopsy: 5.7 percent (gastroenterology)
Lesion removal colonoscopy, snare techniques: 4.4 percent (gastroenterology)
Injection foramen epidural lumbar, sacra: 4.1 percent (orthopedics)
After cataract laser surgery: 3.9 percent (ophthalmology)
Injection spine: lumbar, sacral (caudal): 3.6 percent (orthopedics)
Diagnostic colonoscopy: 3.6 percent (gastroenterology)
Injection paravertebral: lumbar, sacral: 2.2 percent (orthopedics)
Injection foramen epidural add on: 2.1 percent (orthopedics)