28 things for ASC leaders to know for November

Here are 28 updates from the last month.

Congress approves 2-year budget cut for provider payments
Congress passed a two-year budget deal that includes a 2 percent cut in Medicare provider payments. The budget cut raises funding levels and suspends the debt limit until 2017. Congress approved the healthcare budget cuts to generate the funding needed to offset other budget increases across the federal government.

More physicians not selling practices
A recent CareCloud Practice Profitability Index survey found nearly 59 percent of physicians are not planning to sell or merge. In 2014, 54 percent of respondents said they were not planning to sell or merge their practice.

CMS adds 17 new procedures to the ASC payable list
The Centers for Medicare and Medicaid Services released 17 new ASC payable codes along with the 2016 ASC payment rule. Read about the new codes here.

Colorado to vote on universal healthcare in 2016
Coloradans will vote on whether Colorado will be the first state to implement universal healthcare. The initiative, ColoradoCare, will be featured on the 2016 ballot and listed as Initiative 20, "State Health Care System."

AmSurg takes $7.6B TeamHealth bid off the table
AmSurg's $7.6 billion takeover bid for physician outsourcing services company TeamHealth had a deadline of Tuesday at 4 p.m., but the surgery center company withdrew the offer approximately a day ahead of the deadline. TeamHealth said AmSurg's cash-and-stock offer still undervalued the company, leading AmSurg to retract the offer.

UnitedHealth considers pulling out of ACA
UnitedHealth Group is potentially pulling out of the Affordable Care Act due to huge financial losses totaling hundreds of millions of dollars. In October, the payer said it planned to sell coverage through the ACA in 11 more states in 2017. However, UnitedHealth will record losses of $275 million in the fourth quarter, which the payer, in part, attributes to its ACA plans.

AMSA, Public Citizen demand an investigation into resident clinical trials
The American Medical Students Association and Public Citizen, a watchdog group, are calling for an investigation into "unethical" clinical trials, which require first-year medical residents to work up to 28 hours or more at a time. The groups sent a letter to the Office for Human Research Protections at the Department of Health and Human Services and the Accreditation Council for Graduate Medical Education. In the letter, the groups claim the medical trainees and patients are exposed to a variety of risks, including exposure to blood-borne pathogens.

CMS raises outpatient MIS SI joint fusion payment 14%
The Centers for Medicare and Medicaid Services issued the 2016 Hospital Outpatient Prospective Payment System recommendation for sacroiliac joint fusion, increasing the outpatient payment when billing the CPT 27279. The payment will increase from $9,266 to $10,538, a 14 percent increase, effective Jan. 1, 2016.

CMS issues final rule for ACO fraud
On Thursday, CMS issued a final rule about accountable care organization fraud. The rule finalizes waivers of the physician self-referral law known as Stark law, the Federal Anti-Kickback Statute and the civil monetary penalty for beneficiary inducements. The interim final rule has been in place since Nov. 2011. The final rule outlines five waivers — ACO pre-participation waiver, ACO participation waiver, shared savings distribution waiver, compliance with the physician self-referral waiver and waiver for patient incentives.

CMS cuts to colonoscopy reimbursement finalized
CMS has released its CY 2016 Physician Fee Schedule Final Rule, and the final rule includes reimbursement cuts for colonoscopy. The reimbursement cuts were initially proposed in July. The reimbursement cuts for some procedures are more than 17 percent.

Health exchange spurs voters' rights issues
The government is offering voter registration for those Americans who enroll in health plans through the online federal exchange. Several voting rights groups claim the registration violates federal law. The group says while state-based changes comply with the "motor law," which orders states to give those applying for a driver's license or public assistance the opportunity to register to vote, the federal exchange does not comply with the law.

Top 10 states with largest % of uninsured people
There are 41.9 million uninsured people in the United States, according to Kaiser State Health Facts. Texas, Nevada, Arizona, Florida, Wyoming, North Carolina, Georgia, New Mexico, Alabama and Alaska compose the top 10 states with the highest percentage of uninsured people.

ASC patient collections as a % of total revenue
Patient revenue represents nearly $11 billion annually of an ASC's total revenue, according to a Navicure report. Nine percent of ASCs had greater than 41 percent of total revenue as patient revenue.

DePuy Synthes launches ASC solutions program for outpatient joint replacements
DePuy Syntheses launched the DePuy Synthes Advantage Outpatient Solutions Program. The program facilitates best protocols and practices for joint replacement in ASCs and outpatient hospitals in the United States.

Most voters unaware of Connecticut's ASC tax
The Connecticut Citizens for Affordable Health Care recently polled voters in the state on the new 6 percent provider tax on same-day surgeries performed at ASCs in the state. Seventy-nine percent of voters polled didn't know about the tax. Once made aware of the tax, 81 percent of the survey's respondents disapproved of the tax. The state's ASCs are already subject to sales and local property taxes.

Surgery Partners Q3 revenue up 214%
Surgery Partners reported revenue of $239.6 million for the third quarter of 2015, up 214 percent from the third quarter of 2014. For the third quarter, Surgery Partners reported same-facility revenue reached $252.7 million, a 12.7 percent increase from the same period the year prior.

Medical Facilities reports Q3 results
Medical Facilities reported revenue from operations of $73.1 million, down 1.5 percent, from the same period the year prior. The company's income from continuing operations fell to $14.7 million in the third quarter compared to $16.6 million for the third quarter of 2014.

Tenet, Baylor Scott & White Health partner on 5 Texas hospitals
Tenet Healthcare and Dallas-based Baylor Scott & White Health partnered to jointly own Centennial Medical Center in Frisco, Doctors Hospital at White Rock Lake in Dallas, Lake Pointe Medical Center in Rowlett, Texas, Regional Medical Center at Sunnyvale and Baylor Medical Center at Garland.

Physician organizations urge federal antitrust enforcers to stop insurance mega-mergers
The American Medical Association sent a letter to the Department of Justice imploring the agency to ban the recent insurance mega-merger deals last week. The AMA urges the Department of Justice to block the pending Anthem/Cigna and Aetna/Humana mergers, claiming the mergers would stifle competition

Which states boast the highest and lowest uninsured rates?
Texas had a 20.8 percent uninsured rate in the first half of 2015, according to The New York Times. Florida (15.2 percent) and Mississippi (14.2 percent) followed. Illinois, which expanded Medicaid, saw a drop in its uninsured rate from 15.5 percent in 2013 to 8.8 percent in 2015.

Joint Commission releases annual quality, safety report
The Joint Commission released their annual quality and safety report on Monday. The report is comprised of data that was collected beginning Jan. 1, 2014. Nearly 31.5 percent of all Joint Commission-accredited hospitals earned the 2015 Top Performer on Key Quality Measures recognition, with at least one Top Performer hospital in each state.

The Joint Commission celebrates 40 years of ambulatory healthcare accreditation
The Joint Commission presently accredits 2,100 ambulatory care organizations throughout the nation. The organization's accreditations support 8,100 sites of handing with more than 83 million patient visits annually.

Cigna, Chicago physicians collaborate to improve care and reduce costs
Cigna is collaborating with Alexian Brothers Clinically Integrated Network and Midwest Center for Women's Healthcare, both located in Chicago, on programs to improve care coordination and minimize costs. The care programs are part of Cigna Collaborative Care, a value-based model that utilizes incentives to engage healthcare professionals and facilitate improved health, affordability and customer experience

Geisinger to offer refunds to unsatisfied patients
Pennsylvania-based Geisinger Health System is starting to offer a money-back guarantee to patients who received care at its facilities. Patients use a smartphone app to detail their experience to the system, and then request a refund if they are not satisfied with the care they received.

American College of Surgeons appoints Dr. Valerie Rusch chair of board of regents
The American College of Surgeons elected Valerie W. Rusch, MD, its chair of the board of regents. Previously, Dr. Rusch served on various ACS committees and is currently a fellow of the American College of Surgeons.

Blue Cross Blue Shield creates a new patient-focused care network, Blue Distinction Total Care
Total Care is comprised of nearly 450 patient-focused care programs with approximately 118,000 medical professionals across 37 states. The plan emphasizes the need to spend time on prevention, holistic care and personalized care planning for patients.

Report shows leading countries spend nearly 16% of their total gross domestic product for health funds
The Organization for Economic Co-operation and Development report found the United States allots about $8,713 per person for annual healthcare, and Turkey and India spend less than $1,000 per person annually for healthcare costs.

88% of US nurses would choose different practice setting
Merely 56 percent of RNs would choose the same career path if they could do it over again. Only 22 percent of RNs would choose the same practice setting. The average annual gross salary for RNs totals $79,000. An APN nurse anesthetist receives an average annual gross salary of $170,000.

More healthcare news:
Top health official pushes for price transparency — 5 points
Colorado panel to analyze healthcare costs — 5 points
CMS Acting Administrator calls for more drug pricing transparency: 3 notes

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