COVER STORY
the forefront of price transparency. Whether simply through pre-surgi- cal phone calls, informing patients of their procedure and their financial responsibility or the actual posting of consumer costs for procedures, as mandated in Colorado, we have led the way in educating the public. In 2019, the ASC industry can continue to leverage its cost-effec- tiveness over other venues of care by informing consumers of the cost of care. Unfortunately, price transpar- ency initiatives driven by state leg- islatures don’t often achieve their stated goals.
Instead, incomplete
data is collected or a law is created to provide transparency in some areas of health care but not others, or a meaningless requirement is enacted that is unenforceable due to limited compliance budgets. These examples illustrate the challenges we still must face. It will be vital to ensure any legislation that is proposed or passed improves transparency across the board, is beneficial to the consumer and does not make health care more confusing to patients.
Single Payer, Universal Coverage and Medicare for All
The dialogue both nationally and locally continues to heat up as it relates to a universal, single payer, or “Medicare for All” health care sys- tem. This will not diminish in 2019. At the state and national level, poli- ticians are making universal cover- age part of their 2018 electoral season platform. In many segments of the population, there is increasing sup- port for such a change. Whatever your political lean- ings or view on the topic, turning a blind eye to the events is equivalent to burying one’s head in the sand. As an industry, we will need to remain involved to ensure we have a voice in the future of health care. As indi- vidual ASC team members, manag- ers, owners or operators, we will need
to ensure our systems and processes can handle a migration to one of these models, should it occur. I am reminded of a conversation I had with a group of multispecialty physician ASC owners whose prac- tices and ASCs are 80 percent Medi- care/Medicaid. They said that they had essentially been living under a single-payer system for some time. Due to their personal situa- tion, they did not seem to have the sense of fear and dread I encounter with other groups. All of us should take time in 2019 to understand and address what a potential change like this could mean for our businesses and industry.
Advocacy
Whether it is federal or state bills addressing price transparency, sin- gle payer or universal coverage, or any regulations impacting access to ASCs, political advocacy in 2019 will be paramount to the ASC industry’s health. As we close out 2018, ASCA appears poised to make gains for all of us on a federal level and, if suc- cessful, advocacy and the aggregate actions of our political body will have been the reason.
In addition, state associations continue to promote the ASC indus- try and counteract forces attempt-
18 ASC FOCUS JANUARY 2019 |
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ing to stymie progress on a statewide level. ASCA, as well as each indi- vidual state association, can only be successful with the support of all our industry stakeholders—physicians, staff, vendors, corporate executives and hospital investors. I experienced a situation in which unelected officials initiated to make a change to a state regulation. This change would have been detrimen- tal to the ability of ASCs to provide a lower-cost site of service to patients and would have reduced patient choice. The state ASC association’s lobbyist relayed that we could expect little to no assistance from members of the state House and Senate due to the association’s lack of political fun- draising over the last several years. This is a classic example of one of my favorite sayings, “What have you done for me lately?” If we want to create change, we all need to get involved in 2019.
Conclusion We live in a dynamic world where exciting new discoveries take place each day and, consequently, health care constantly evolves. From the perspective of our patients, we are excited that the ASC industry contin- ues to grow, as do the services we pro- vide. We must remember, however, that fighting for our patients does not end in the operating room. Unfortu- nately, advocates of the ASC indus- try must battle against various special interests that stand to gain from either slowing or diverting our progress. If I leave you with one thing it is this: remember, if you don’t have a seat at the table in 2019, you are probably what is for dinner. The best time to prepare for change is before it occurs. Get involved.
Robert J. Carrera is the president and chief executive officer of Pinnacle III in Lake- wood, Colorado. Write him at rcarrera@
pinnacleiii.com.
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