At Becker's ASC Review's 24th Annual Meeting: The Business and Operations of ASCs in Chicago on Oct. 27, three ASC leaders gathered to discuss the current legislative landscape and the Ambulatory Surgery Center Association.
Participants in the discussion included:
- William Prentice, CEO of the Ambulatory Surgery Center Association
- Brandon O'Dell, BSN, RN, CEO of Surgery Center of Athens (Ga.)
- Stanford Plavin, MD, ASCA board member; president of Technical Anesthesia Strategies and Solutions; physician at Melville, N.Y.-based North American Partners in Anesthesia
- Conversation moderated by Scott Becker, publisher of Becker's Healthcare
On Washington D.C., and ASCA's current goals
"Congress is not devoting time to legislation right now," Mr. Prentice said. "We have our ASC bill that we're trying to get enacted that has some important provisions we think would help ASCs, but the likelihood of that happening as a standalone enactment is very slim."
"What we're really looking for is an opportunity for when Congress has to pass something. One of these must pass bills, like the budget or tax reform potentially. … We're hoping to get a couple of those provisions added to that must pass bill."
"The [ASC] bill pertains to the Medicare program. One of the [most important aspects] is trying to change the way Medicare updates our rates each year for inflation, so we can keep pace with what they're doing on the hospital side. The other one is to make sure we have a voice on the panel that determines whether or not procedures can be done outpatient. Right now, we have nobody on that panel, and we think we should have a mandatory opportunity to have someone on that panel to have a voice for the ASC community," he concluded.
A practicing physician's take on developing legislation
"Anytime legislators and regulatory people are involved [in healthcare] and are trying to identify the best clinical practices, guided by monetary decisions, you have to balance it out with feedback and input from the clinical side," Dr. Plavin said. "ASCA has done a really good job of making sure the clinical piece is there for decision makers to have when making choices to have patients migrate from hospitals to ASC. [Legislators will] feel confident the patients will do well."
On site of service differential
"The newest thing we've seen [in Georgia] is really site of service differential where the payers are actually encouraging independent physicians to take [a procedure] to an affiliated setting to increase their professional fees," Mr. O'Dell said.
Mr. Becker added that such practices were present within the pain management arena for years, but wondered if it was also present in the ASC setting.
"Absolutely. It's being directed by the payer, and the payers are even reaching out to the patients these days and saying 'Do you know that spine procedure can be done in a lower cost setting?'" Mr. O'Dell said.
Surgery centers under President Donald Trump
"This regulatory environment, that we're going to be in for the next three to seven years, greatly reduces the likelihood of some kind of onerous regulation coming our way," Mr. Prentice said.
On what ASC administrators can do to make an impact
"The things that happen in Washington have real world impacts on us all," Mr. Prentice said. "As much as we might despise the partnership and the back breaking that goes on there, we need to stay involved. You need to know who your lawmakers are and they need to know who you are. I've been skeptical about the ability of Congress to pass things to help us, but they can inadvertently, on any given day pass something that can hurt us."
"I will tell you, we have a great team on my staff representing the ASC model and keeping our ear on the ground, but we need everyone's help to make sure more lawmakers know about the ASC model and how important it is," Mr. Prentice said.