ASCA CEO William Prentice Shares 6 Key Legislative Priorities of the ASC Industry FeaturedWritten by Taryn Tawoda | June 15, 2012
In a session titled "The Key Legislative Priorities of the ASC Industry" at the 10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago, William Prentice, JD, CEO of the ASC Association, discussed the progress of several healthcare policies that directly impact ambulatory surgery centers.
1. CMS continues to rely on the CPI-U. One of the most prominent policy issues affecting surgery centers is CMS' continued reliance on the Consumer Price Index for All Urban Consumers to update ASC payments, Mr. Prentice said. Progress is being made in the form of a bipartisan bill that aims to level the update percentage to that given to hospitals. "CMS is realizing that they have no justification for using the CPI-U for determining our update each year," Mr. Prentice said. "Hospitals get a two percent update, while ambulatory surgery centers get one percent."
2. Changes in regulation this year have focused on quality reporting. "Specifically, ASCs have to start reporting on quality measures that CMS has adopted," Mr. Prentice said. "Yes, it's a regulatory burden, but it's something we have to do, particularly with people wanting to demean ASCs as being of lower quality. We have to prove we're providing equally as good if not better care." Quality reporting is essential for the ASC industry to demonstrate that the care provided is the highest possible quality compared to that of hospitals, he said.
3. CMS discussions have been fairly reasonable this year. Mr. Prentice said he views the discussions as a good sign. "The tipping point with them is understanding the ASC model," he said. "It appears as though flat is the new up when it comes to reimbursement. If our payments are flat, that's a win. We're also seeing a glimmer of hope that CMS is understanding the problems we're facing in terms of ASC reimbursement versus hospital outpatient department reimbursement."
4. Medicare and Medicaid challenges still loom. In January, Mr. Prentice said, the Medicare program will be one of the many government programs to receive a two percent cut in funds. "That one percent represents $40 million per year in payments," he said.
5. ASCs may exist within ACOs. Mr. Prentice concluded the session by addressing how ASCs might exist within accountable care organizations. "It really depends on who is driving the ACO," he said. "ACOs will be mostly driven by the hospitals, and some hospitals see the values of ASCs and invest in them. It will vary by marketplace." He said he is primarily concerned that ACOs will lead to a "one size fits all" healthcare model that eliminates competition. "Once that competition is out, it's not coming back," he said.
6. It is uncertain if joint ventures will be a beneficial option for ASCs. When asked if it would be beneficial for hospitals to prepare for the rise of ACOs by pursuing joint ventures with hospitals, Mr. Prentice said, "There is no one answer. From a national standpoint, we're trying to convey to policymakers our concern about ACOs squeezing out competition. It's not helpful in the long term to the American healthcare system, and it's not helpful to patients."
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