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OOSSMark2012 – Benchmarking Performance for 2011
Benchmarking Update for 2012
Kent Jackson PhD. OOSS Vice President Member Research & Development
The 2012 OOSSMark Program, including the Annual OOSS Benchmarking Survey of 2011 results, is set to launch on Friday, June 1, 2012. With five years of benchmarking development, OOSS has established the single most comprehensive and annualized approach to enable ophthalmic-oriented ASCs (single and multispecialty) to compare practices and performance with 200+ facilities across the country. By completing an online survey anytime from June 1st to December 31st, participating facilities receive a custom report including detailed clinical and business benchmark measures.
All current OOSS members and previous participants in the program will receive invitations via email on June 1st. Participation of non-OOSS members is welcome and complimentary to all considering the time and effort required to participate and the value of the shared information. All reported information is aggregated and individual facility responses are shared only with the participating facility.
If you would like more information or wish to participate in the survey please email Kent Jackson at kjackson@ooss.org.
Watch for additional announcements regarding the expanded OOSSMark Program, including a new OOSSMark Blog and OOSSMark Tools for Success. (more…)
The OOSS Legislative and Regulatory Agenda for 2011 — A Quick Look Back
While we all await the impact of the forthcoming elections and a critical Supreme Court opinion on the landmark health care reform bill and Big Medicine continues its battle to resolve the seemingly endless SGR problem, the ASC community made real progress in satisfactorily resolving a number of important regulatory concerns. We’ll discuss these in greater details in an early January OOSS Update Online, but let’s highlight these accomplishments before ushering in what will be a very busy 2012 in the Nation’s Capital.
• Same Day Surgery. OOSS was instrumental in persuading CMS to repeal the onerous Medicare Condition for Coverage that prevented surgeons from performing Yag and other procedures on a patient in an ASC on the same that the patient was referred to the facility.
• Higher ASC Update. Although CMS again rejected the ASC industry’s recommendation that facilities receive the Hospital Market Basket rather than the Consumer Price Index as an annual inflator, the agency did increase the ASC update from 0.9 percent in the proposed rule to 1.6 percent in the final regulation.
• Quality Reporting Program Delayed and Improved. The final ASC payment rule delayed the implementation of the new ASC quality reporting program until October 1, 2012, nine months later that the proposed January 1 start date – a change welcomed by the surgery center community. Moreover, the measures adopted by the agency were developed by the ASC Quality Collaboration, of which OOSS is a member.
• Growing Support for ASC Quality and Access Act. OOSS joins the ASC Association and other organizations in vehemently supporting The ASC Quality and Access Act of 2011, which represents a legislative wish list of our industry’s priorities in Washington. Through aggressive lobbying, grassroots activity by our members, and targeted political support of our Hill allies with OOSPAC funds, cosponsorship of the legislation has grown to include 5 Senators and 38 Representatives.
Stay tuned for a detailed retrospective on our activities in Washington this past year and a look at the OOSS legislative and regulatory agenda for 2012.
Enhance the Performance of Your ASC with New Online Modules
Many ophthalmologists have ownership interests in ambulatory surgical centers (ASCs). A majority of ophthalmic surgical cases in the US are performed in ASCs. To help ASCs perform at optimum efficiency and quality, the American Academy of Ophthalmic Executives (AAOE) have developed, with cooperation from the Ophthalmic Outpatient Surgery Society (OOSS), the Successful Ophthalmic ASC collection. Titles include: Administration, Operations and Procedures for the Ophthalmic ASC (#012404V); Complete Guide to Coding (#012405V); Designing and Building the Ophthalmic ASC (#012401V); Financial Reporting and Management (#012400V); and Managing ASC Quality and Performance (#012402V).
Download these modules today. Each is $45 for members and $60 nonmembers. Get 10% off when you purchase all five.
For more information, visit www.aao.org/store and click “Practice Management/AAOE.”
POSSIBLE REPEAL OF BURDENSOM CMS LIMITS ON SAME DAY SURGERY NOW ON THE HORIZON
According to a White House Report issued this week, several regulations of interest to ASCs are part of a regulatory relief plan being undertaken by the Obama Administration and HHS, including one that OOSS has vociferously objected to since its inception two years ago. This regulation, part of the Medicare Conditions for Coverage, prohibits, except under narrow circumstances, a patient from receiving surgical care in an ASCon the same day that the surgeon refers him to the facility; the rule has had the onerous effect of precluding same day diagnosis for and performance of Yag procedures, much to the inconvenience of beneficiaries and consternation of surgeons. In April, OOSS Past-President Dr. Larry Patterson met with CMS officials to articulate our concerns with this rule and urge that it be repealed. We are pleased that the government now estimates that overturning this regulation will save Medicare $50 million annually.
The White House and HHS will also be reviewing rules governing the list of operating room emergency equipment that ASCs must have available as well as potentially duplicative infection control requirements.
The HHS regulatory relief plan may be reviewed at: http://www.slideshare.net/whitehouse/healthand-humanservicesregulatoryreformplanaugust2011
OOSS QUARRELS WITH CMS 2012 PROPOSED ASC PAYMENT RATES AND OFFERS IMPROVEMENTS TO NEW QUALITY REPORTING PROGRAM
OOSS joined the AAO and ASCRS in submitting comments to the Centers for Medicare and Medicaid Services (CMS) regarding its proposed 2012 ASC payment regulation. As in past years, we strenuously objected to CMS’ use of the Consumer Price Index (Urban) as the update factor for ASCs, urging instead that facilities be afforded the Hospital Market Basket, which is provided hospital outpatient departments and is typically about a point higher.
This regulation was significant in that CMS also proposed that ASCs be subject to quality reporting commencing January 1, 2012 and be subject to penalties in 2014. OOSS recommended that the new program be voluntary through 2013 and that the performance period commence in 2014. Moreover, penalties should start at no greater than 0.4 percent, consistent with the inpatient hospital program. OOSS comments also included substantive recommendations regarding data collection, measure development, future topics, and other important issues.
OOSS’ comments to CMS may be reviewed at FINAL AAO-ASCRS-OOSS Comments ASC 2012 NPRM 8-30-11.
The CMS proposed rule may be viewed at: http://www.gpo.gov/fdsys/pkg/FR-2011-07-18/pdf/2011-16949.pdf
For more information, contact Mike Romansky at mromansky@OOSS.org.
2012 ASC PAYMENT RULE: MODEST PAYMENT ADJUSTMENTS; NEW QUALITY REPORTING REQUIREMENTS
As reported in a recent OOSS Washington Update Online, CMS issued its proposed 2012 Medicare ASC payment regulation. To Review This Update, Click here. To summarize the key elements of the rule:
- ASCs would receive an inflation update of 0.9 percent (based on the CPI-U estimate of 2.3 % less a statutorily mandatorily mandated “productivity adjustment” estimated to be 1.4%). OOSS will seek the same cost-of-living adjustment provided to hospitals, the Hospital Market Basket, which is about a point higher.
- Facilities would be required to report their results, where relevant, with respect to the following measures: patient burns; patient fall in the ASC; wrong site, wrong side, wrong patient, wrong procedure, wrong implant; hospital transfer/admission; prophylactic IV antibiotic timing; appropriate surgical hair site hair removal; and, prophylactic antibiotic (cephalosporin). In 2013, a surgical site infection rate measure would be added. Although we know that penalties commence in 2014, it not precisely clear as to whether they will apply to submissions made in 2012 and/or 2013, how much data is needed for a sample size, what the size of the penalties will be, etc.
OOSS will keep you posted as we learn more about this important regulation and we will provide you the information and tools to submit your own comments to the agency prior to the August 31 deadline
ASC REFORM LEGISLATION GAINS CONGRESSIONAL AND SURGICAL COMMUNITY SUPPORT
ASC REFORM LEGISLATION GAINS CONGRESSIONAL AND SURGICAL COMMUNITY SUPPORT
As reported earlier this summer, House and Senate health leaders introduced landmark legislation – The Ambulatory Surgical Center Quality and Access of 2011 — developed by OOSS, the ASC Association, and others that would accomplish several important goals. First, it would provide ASCs with the same inflation update afforded hospital outpatient departments. Second, it would reverse CMS’ current regulation that precludes an ASC from performing surgery on a patient the same day that the surgeon refers the patient to the facility, a policy that has unnecessarily inconvenienced thousands of Yag patients. Third, it provides important protections and safeguards for facilities in contemplation of CMS’ implementation of a new ASC quality reporting program. For a detailed Bill Summary, click here: QUALITY AND ACCESS ACT OF 2011.
The House version of the bill, H.R. 2108, is co-sponsored by: Representatives Pete Sessions (R-Tx); Shelley Berkley (D-Nv); Michael Burgess (R-Tx); Bill Cassidy (R-La); Tim Griffin (R-Az); Ralph Hall (R-Tx); Larry Kissell (D-NC); John B. Larson (D-Ct); Kenny Marchant (R-Tx); Cathy McMorris Rodgers (R-Wa); Jerry McNerney (D-Ga); Randy Neugebauer (R-Tx); Richard Nugent (R-Fl); David P. Roe (R-Tn); Ed Whitfield (R-Ky). The Senate version of the bill, S. 1173, is sponsored by Senator Ron Wyden (D-Or) and co-sponsored by Senators Mike Crapo (R-Id) and Mary Landrieu (D-La).
The American College of Surgeons (ACS), which represents more than 75,000 surgeons, has also notified Congress of its support for this landmark legislation.
You will receive an OOSS Washington Update Online within the next few days requesting your grassroots efforts in securing more cosponsors to this important legislation. Just a few clicks of the keyboard is all it will take to ask your Representative or Senator to cosponsor the bill. Stay tuned . . .
CMS RELEASES PROPOSED CY 2012 ASC PAYMENT REGULATION: MODEST ADJUSTMENTS UP AND DOWN, NEW QUALITY REPORTING REQUIREMENTS
On July 1, the Centers for Medicare and Medicaid Services (CMS) issued proposed CY 2012 payment rates for hospital outpatient departments (HOPD) and ambulatory surgery centers (ASC). The proposed regulation will soon be published in the Federal Register, after which time OOSS and other interested parties will have an opportunity to submit public comments. (more…)
LANDMARK ASC REFORM LEGISLATION INTRODUCED IN CONGRESS!
I am delighted to report that, last week, health care leaders in the both the House of Representatives and the US Senate introduced legislation, The Ambulatory Surgical Center Quality and Access Act of 2011, that is critical to the ability of ASCs to provide high quality and cost-effective surgical care to Medicare beneficiaries in the future. (more…)
WASHINGTON ALERT: HHS TO CONDUCT REVIEW OF RULE RESTRICTING SAME DAY SURGERY
Under a plan released last week to review myriad regulations that are potentially out-of-date, unnecessary, excessively burdensome, or in conflict with other regulations, the US Department of Health and Human Services (HHS) announced that it will conduct, specifically, a review of a provision of the Medicare Conditions for Coverage issued in 2009 that restricted ASCs from performing surgery on the same day it was scheduled, unless the surgery was deemed to be medically necessary. This rule has effectively precluded ophthalmic ASCs from performing Yag laser services on the same day that the need for surgery is diagnosed, at great cost and inconvenience to Medicare patients and their families. (more…)
