At the 18th Annual Ambulatory Surgery Centers Conference in Chicago on Oct. 29, Larry E. Patterson, MD, medical director of Eye Centers of Tennessee, and Michael A. Romansky, JD, Washington Counsel and vice president of corporate development for the Outpatient Ophthalmic Surgery Society, discussed current trends in ophthalmology in ASCs.
Dr. Patterson said ophthalmic ASC market drivers include the following:
• Growth in cataract volume. An Ophthalmic Market Perspectives report estimated the volume of cataracts has grown from 2.4 million in 2000 to 3.2 million in 2010, Dr. Patterson said.
• Growth in volume attributable to new technology, such as premium intraocular lenses and femtosecond lasers. Dr. Patterson addressed the economic viability of the femtosecond laser. He said while it holds great promise, currently it is not feasible for ASCs to use profitably because of its high cost. "It's going to be great, but it's not quite ready for prime time," he said.
• Integration of vitreoretinal surgery into ASC. Vitreoretinal surgery can be profitable because reimbursement rates for the procedure are increasing, according to Dr. Patterson. However, the ASC must have enough volume to offset the cost of equipment and supplies and have physicians who can perform the procedure efficiently.
• Hospital acquisitions of ophthalmic ASCs.
• Emergence of ACOs.
Dr. Patterson also discussed trouble spots for ophthalmic ASCs attempting to meet the Medicare ASC conditions for coverage that began May 2009. Some areas to focus on include the following:
• Credentialing of physicians. Physicians who perform laser procedures must be properly credentialed.
• Physician documentation. Physicians must document a history and physical examination of the patient.
• Compounding. ASCs should know the difference between compounding, which makes a new medication and is prohibited; and mixing, a permissible process in which the medications remain the same.
• Instrument transportation. Instruments have to be in a closed container when transported from the sterilizer to the OR, even if the rooms are contiguous.
5 Key Points on Ophthalmology, ENT and Podiatry in ASCs
5 Key Issues for Surgery Centers
Dr. Patterson said ophthalmic ASC market drivers include the following:
• Growth in cataract volume. An Ophthalmic Market Perspectives report estimated the volume of cataracts has grown from 2.4 million in 2000 to 3.2 million in 2010, Dr. Patterson said.
• Growth in volume attributable to new technology, such as premium intraocular lenses and femtosecond lasers. Dr. Patterson addressed the economic viability of the femtosecond laser. He said while it holds great promise, currently it is not feasible for ASCs to use profitably because of its high cost. "It's going to be great, but it's not quite ready for prime time," he said.
• Integration of vitreoretinal surgery into ASC. Vitreoretinal surgery can be profitable because reimbursement rates for the procedure are increasing, according to Dr. Patterson. However, the ASC must have enough volume to offset the cost of equipment and supplies and have physicians who can perform the procedure efficiently.
• Hospital acquisitions of ophthalmic ASCs.
• Emergence of ACOs.
Dr. Patterson also discussed trouble spots for ophthalmic ASCs attempting to meet the Medicare ASC conditions for coverage that began May 2009. Some areas to focus on include the following:
• Credentialing of physicians. Physicians who perform laser procedures must be properly credentialed.
• Physician documentation. Physicians must document a history and physical examination of the patient.
• Compounding. ASCs should know the difference between compounding, which makes a new medication and is prohibited; and mixing, a permissible process in which the medications remain the same.
• Instrument transportation. Instruments have to be in a closed container when transported from the sterilizer to the OR, even if the rooms are contiguous.
Related Articles on the 18th Annual Ambulatory Surgery Centers Conference:
Key Issues for Ophthalmology in ASCs5 Key Points on Ophthalmology, ENT and Podiatry in ASCs
5 Key Issues for Surgery Centers