ADVOCACY SPOTLIGHT A State-Based Perspective
from ASC Advocate Rob Schwartz ASCs can make a difference by engaging in the political system and being involved in advocacy, says the executive director of the Colorado and Oregon ASC associations.
How did you become involved in the ASC industry and come to lead sev- eral state ASC associations? SCHWARTZ: My consulting practice, Strategic Resourc- es, was assisting a group of physicians and others to secure a workers’ com-
pensation reimbursement increase that had been frozen in Colorado for seven years. We successfully secured a gener- ous and well-deserved increase. Word of that success spread, and we were asked to meet with Colorado Ambula- tory Surgery Center Association (CAS- CA) leaders who were in major battles with the Colorado Hospital Associa- tion (CHA). We were hired to manage CASCA, and several weeks later, CAS- CA was in a battle with the hospitals in the Colorado state legislature. CAS- CA was trying to defeat two bills that would have crippled the ASC industry in Colorado. It was a major battle, but CASCA prevailed. In the next session, the CHA came back for round two on the same issues. We won again. Word of that success spread, and we became troubleshooters in states that did not have strong lobbyists or staff. We have been
pleased with our success and proud of our association with a great industry.
What do you see as the biggest challenge facing the ASC industry currently on the national and state levels? SCHWARTZ: A major challenge for the ASC industry on the state and national levels is being marginalized because so much of the focus in public policy today is purely on hospitals. This applies to accountable care organizations (ACO), reimbursement, regulatory
measures
and emergency preparedness. A second threat is the paradigm shift among phy- sicians who opt to be employees versus innovative entrepreneurs. Also, states that are not frugal feel that the approach to deficits is to tax more and increase fees. In Oregon, we defeated an attempt to levy a provider tax on ASCs, which would have amounted to $300,000 right off the top of each ASC. We have seen instances of cosmetic taxes being levied on plastic surgeons. It is clear that lib- eral legislators see doctors as the deep pocket. ASCs and physicians need to be part of coalitions that advocate for governments that operate in a more fru- gal fashion. It is also critical to develop
economic impact statements to educate policy makers that ASCs are an impor- tant part of the state economic engine.
What legislative trends are you seeing in Colorado and Oregon that ASCs in other states should be concerned about? SCHWARTZ: One trend worth noting is the effort to reform workers’ compen- sation in a number of states. The effort to cut reimbursement for doctors in this area should be strongly opposed, and a case should be made that ASCs can create public–private partnerships with government to reduce costs for caring for injured workers without diluting quality. Another trend is the creation of exchanges that are expensive to operate and place another burden on the private sector. Undue burden through regula- tory policy is another trend to watch carefully. Life safety regulations can prove to be both expensive and solu- tions searching for a problem.
Your involvement was instrumental in bringing on Senator Ron Wyden (D-OR) as a lead sponsor of the federal legis- lation designed to promote access to ASCs that ASCA supported in the last session of Congress. Could you explain the process of developing strong rela- tionships with elected officials? SCHWARTZ: The Oregon Ambulatory Surgery Center Association (OASCA) is proud that it played a role in secur-
30 ASC FOCUS APRIL 2013
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