Ambulatory Surgery Center Association (ASCA) government affairs specialists suggest seven ways for ambulatory surgery center leaders to become industry advocates and have a positive impact on healthcare policy and legislation.
1. Participate in ASCA's Capitol Fly-Ins. ASCA coordinates several Capitol Hill Fly-In events every year to help ASC administrators, physicians and other advocates meet with their elected officials in Washington, DC. The next event in September will include over 60 representatives from 11 states.
"Members of Congress want to hear about how laws and government policy impacts their constituents, it helps them make better, more informed decisions," says Heather Falen Ashby, assistant director, Government Affairs for ASCA. "Right now our biggest push is the ASC Quality and Access Act of 2013 (H.R. 2500/S.1137). Since previous Fly-Ins this year, we've had several members of Congress sign on to that bill and our lobbying team has met with many others. These events have been really helpful in gaining Congressional support for this legislation and ASC issues of many kinds."
If passed, the ASC Quality and Access Act of 2013 would immediately change the economic measure that Medicare uses to update payments to ASCs each year and ASCs would see a significant impact on their Medicare payment rates well into the future.
"ASC rates aren't currently updated for inflation in the same way as other same-day surgery providers in the US healthcare system," says Kristin Murphy, assistant director, Government Affairs for ASCA. "Under this bill, ASCs would see payment updates tied to the increasing costs of providing medical care instead of updates based on the increasing costs of things like bread and gasoline, as they are now."
2. Stay up to date on current issues. Beyond the ASC Quality and Access Act, several other legislative initiatives now being considered in Congress could have a big impact on surgery centers in the future. These efforts include:
• Making sure that legislators regulate compounding pharmacies appropriately to ensure that they can provide safe and effective drugs to healthcare facilities without exacerbating drug shortages;
• Temporarily excluding patient encounters in the ASC setting from counting toward the "meaningful use" requirements so that physicians can avoid penalties tied to using certified electronic medical records (EMR), since currently no EMRs are certified for the ASC space.
"Starting in 2014, physicians will have to meet 'meaningful use' requirements that include making certain that 50 percent or more of their patient encounters occur in a setting that uses a certified EMR," says Falen Ashby. "However, there isn't a certified EMR for ASCs, which puts many physicians who treat a significant percentage of their patients in an ASC in a difficult position. We are working with several members of Congress on legislation that includes a three-year reprieve from penalties for patient encounters in ASCs so that, for now, those patient encounters won't count against the 50 percent threshold that these physicians need to meet."
ASCA is currently involved in leading efforts to develop a certified EMR for the ASC setting, adds Falen Ashby. ASC leaders who fully understand the nuances of this issue and many others like it are able to effectively lobby their representatives in Washington, DC, and advocate for legislation that supports the industry.
3. Become involved in grassroots efforts. ASCA sends out weekly government affairs updates that give its members detailed information about different efforts that the organization supports and helps them get and stay involved. The weekly government affairs updates that ASCA sends its members also include information about how to contact their members of Congress.
"We run a grassroots advocacy center on our website," says Murphy. "So, when a piece of legislation is introduced, we send out an alert to our membership giving them the opportunity to send a personalized message to their senators and representatives. We have a sample letter, but it's fully editable, so they can customize it for their members. Data shows that customized contact from a constituent is one of the most influential methods for reaching congressional members and their staff."
The website also helps connect ASC leaders, based on their email or ZIP code, with their members of Congress.
4. Host facility tours for elected officials. Whether you invite local or national officials, hosting policy makers at your ASC and giving them an opportunity to tour your facility can make a big difference in how they conceptualize ASCs. The tours allow them to see firsthand the high quality, cost-effective care that ASCs offer, and the sterile, safe and patient-friendly environment ASCs provide.
"The representatives walk through the preoperative area and waiting rooms, and some even put on a sterile gown, cap and booties to see the operating room (OR) area," says Murphy. "Otherwise, they can look through the doors and see that the ASC ORs look just like hospital ORs."
During the tour, introduce your lawmakers to your ASC's staff and the surgeons who work at your center. After the tour, have a conversation with your ASC's visitors about the important issues for the ASC industry and what your center needs to continue to be able to provide safe, cost-effective care.
"After an ASC hosts a member of Congress or its state legislature in their ASC, representatives from the ASC follow up with them locally and ASCA's staff in Washington follows up with them as well," says Murphy. "ASCA can help ASCs facilitate and prepare for these visits. After these visits, a high percentage of the representatives have signed on to our legislation or otherwise supported us in our legislative efforts."
5. Talk with legislators about the policy issues that concern them most, making certain that the information you present is easy to understand and absorb quickly. If you are able to coordinate an audience with an elected official, or an official's aid, know how to present the information that will be most important in helping them make the decisions that they will need to make. Individual ASCs and physicians have great success stories to tell, and it's important to stress the safety and cost-effective advantages that ASCs have over other care settings.
"Even members of Congress who don't know the ins and outs of the healthcare industry do know that everyone wants to save on Medicare and promote efficiency," says Murphy. "We want to show policymakers that ASCs are clean, well-run, modern facilities that deliver topnotch patient care at an economical price."
Also touch on issues such as:
• Accreditation and certification — All ASCs that accept Medicare patients must be Medicare-certified. In addition, many ASCs take the additional step of becoming accredited by the same highly regarded organizations as HOPDs;
• Infection control — ASCs have mandatory and voluntary infection control reporting programs, and consistently report low infection rates and high outcomes of care; and
• Patient satisfaction — Patients surveys indicate a 92 percent satisfaction rate with the service that ASCs provide.
6. Support legislators who support ASCs. ASCA manages ASCAPAC, the only political action committee representing the entire ASC community. ASCAPAC's goal is to support members of Congress who are ASC champions and work to ensure that they stay in Congress.
"Joining ASCAPAC is akin to making an investment in your career," says Falen Ashby. "Your future is tied to the ASC where you work, which is directly impacted by the decisions made in Congress. ASCAPAC shows members of Congress who support us and take a stand on ASC issues that we appreciate their support and ensures that they have the resources they need to stay in Congress."
For ASCA members, ASCAPAC is a unique opportunity to get involved in ASC advocacy because it offers many different programs, adds Falen Ashby. "We have hosted events across the country and are working on more policy-oriented strategy sessions. For example, in October ASCAPAC is hosting a strategic seminar on the future of pain management in the ASC setting. Over two days, leaders in pain management will gather to discuss challenges facing their ASC practices and strategize on ways to protect their future.
"ASCAPAC is one of three tools in our advocacy strategy, along with legislative and regulatory lobbying and member engagement. Without strong support from ASCA members for each tool, our overall strategy cannot be as successful."
7. Make sure that you are a member of ASCA and your state ASC association. "In Washington, you can't underestimate the power of numbers, and ASCA's ability to represent the ASC community there with a unified voice is critical to future successes on behalf of ASCs across the country," says Murphy. "State ASC associations provide the local expertise and personal involvement needed to help guide state policy-making decisions that often have ramifications for the ASC community that extend well beyond their state borders. Working together, state associations and ASCA can have a powerful impact. They also provide individual ASC professionals with the tools they need to get and stay involved. It is critical that ASC professionals support them both."
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