Reducing Medicare Costs by Migrating Volume from Hospital Outpatient Departments to Ambulatory Surgery Centers

From Advancing Surgical Care (Download PDF)

More than 5,800 Medicare-certified ambulatory surgery centers (ASC) provide outpatient services to Medicare beneficiaries. On average, Medicare pays ASCs one-half of hospital outpatient department (HOPD) rates for the same procedures, meaning that every time a procedure for a Medicare beneficiary is performed in an ASC instead of an HOPD, the Medicare program saves money. This report seeks to update estimates of those savings to the Medicare program for the period 2011 to 2018 and project those savings for 2019 through 2028.

Surgeons Migrate to ASCs as Surgeries Move to Ambulatory Settings

From OutpatientSurgery

It’s no secret that the ongoing coronavirus pandemic has challenged American health systems in ways that they are not used to being challenged. Many have had to adjust rapidly to best meet the needs of their patient population, while doing what they can to stay afloat financially. Among the most attractive solutions to this problem is the migration of procedures to ambulatory surgical centers (ASCs)

10 Big Challenges for ASCs

One year ago, many ASCs were closed or at limited case volume to divert resources to hospitals treating COVID-19 patients.A year later, the pandemic has had some silver lining in driving more cases outpatient, but there are several challenges ahead. ASC owners and operators will have to navigate their organizations through a new healthcare ecosystem emerging in the next 12 to 24 months.
From Becker’s ASC:

Ten challenges:

1. Boosting case volume. The COVID-19 pandemic, and other natural disasters last year, depressed ASC volume because centers temporarily shut their doors. While many ASCs have resumed operations, other factors are keeping them from reaching 100 percent capacity. Social distancing measures and lack of supplies force centers to lower their daily case volume. Unemployment in some areas will continue to challenge surgery centers, as patients don’t have access to insurance or necessary funds to undergo elective surgery. ASCs will need to find new ways to boost case volume, through facility expansion, adding services, employer partnerships or accepting alternative payment plans. Read more

Six AI updates in GI for 2021

Artificial intelligence has a growing presence in gastroenterology. From colonoscopy procedures to imaging techniques, here is a link to six AI updates in GI so far in 2021:

Original article From Becker’s ASC

AI in GI: 6 updates in 2021

Artificial intelligence has a growing presence in gastroenterology. From colonoscopy procedures to imaging techniques, here are six AI updates in GI so far in 2021:

1. The FDA granted de novo clearance for Medtronic’s first AI system for colonoscopies. The endoscopy module, GI Genius, uses AI to identify colorectal polyps, according to an April 12 news release.

2. Pristine Surgical and NexOptic have agreed to combine their technologies for a single-use endoscopic visualization platform. Pristine Surgical’s single-use endoscopes will use NexOptic’s AI imaging technology, All Light Intelligent Imaging Solutions, according to an April 7 news release.

3. A team at Washington University in St. Louis developed an imaging technique for rectal tissues to assess risk management of CRC. Biomedical professor Quing Zhu, PhD, and her team created the imaging technique, acoustic resolution photoacoustic microscopy coregistered with ultrasound, and paired it with AI.

4. GI-focused software companies Iterative Scopes and Provation partnered to link Provation’s GI documentation software with Iterative Scopes’ inflammatory bowel disease data and AI insights, according to a March 17 news release.

5, A partnership reached between Iterative Scopes and Eli Lilly Feb. 18 will explore how AI can improve understanding of IBD pathophysiology and target identification. Iterative Scopes closed a $5.2 million seed round in January 2020.

6. Chattanooga, Tenn.-based Erlanger Health System began a clinical trial to test an AI device used to increase polyp detection during colonoscopy, thechattanoogan.com reported Feb. 8.

CMS Will Eliminate Inpatient-Only Procedure List by 2024

This year, ASCs can perform and be paid for hundreds of additional procedures.

JOINT SUPPLEMENT CMS will now pay for total hip replacements performed at ASCs.

CMS’s Outpatient Prospective Payment System and Ambulatory Surgical Center final rule, which took effect on January 1, further blurs the lines between inpatient and outpatient surgical care, as well as between ASCs and HOPDs within the outpatient sphere.

The big news is the gradual elimination of the inpatient-only procedure list. This year, CMS has removed a total of 298 mostly musculoskeletal procedures from that list, and now will pay for them in HOPD settings when clinically appropriate. By 2024, the remaining 1,400 or so procedures on the inpatient-only list will be removed. Read more