Vol. 1, No. 3


Working for You: How ASCA Helps ASC Physicians


By Alex Taira


As it works to support ASCs and patient access to ASCs, ASCA invests a significant amount of time and attention to regulatory and


advocacy efforts that promote the interests of ASC physicians. Working with policymakers and in coalitions built around specific physician issues, ASCA has always found greatest success when ASC physicians are involved in providing input and championing the causes that help make ASCs an attractive care setting for physicians and patients alike.


A Collaborative Effort One example of the work ASCA does on behalf ASC physicians is the formal comment letters that the association submits each year to the Centers for Medicare & Medicaid Services (CMS) on the proposed and final versions of the agency’s Hospital Outpatient Prospective Payment System /ASC, Inpatient Prospective Payment System (IPPS) and Medicare Physician Fee Schedule (MPFS) rules. In all its comments, ASCA seeks to ensure that physicians operating in ASCs have access to fair payment structures and technological incentives that are at least equivalent to all other care settings.


When provisions in these rules affect ASCs and ASC physicians in subtle ways, their impact may not become apparent until years later. In other cases, their effect is immediately clear. This year, for example, the IPPS final rule put in place a definition that has immediate ramifications for ASC physician payment adjustments


under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program (QPP). ASCA has also responded with formal comments to proposed and final versions of the MACRA rule. Comments have advocated for lower performance thresholds, expanded exemption criteria, performance category reweighting and more. ASCA will continue to participate in the dialogue surrounding this issue in live forums and future written responses.


ASCA in-person outreach at the US Department of Health and Human Services (HHS) and its relevant sub- agencies includes representing the interests of ASCs and ASC physicians at roundtable discussions and listening sessions, conducting meetings with agency leaders and working to ensure that voices from the ASC surgical specialties are represented on CMS advisory committees. ASCA is eager to work with any ASC physician interested in serving on or as an advisor to the federal advisory bodies and committees with which we work. Contact Alex Taira at ataira@ascassociation.org.


Physician Representation ASCA routinely helps build and participates in coalitions around issues relevant to ASC physicians. These include everything from granular level surgical issues (e.g., reimbursement rates for specific codes or addition of procedures to Medicare’s ASC-payable list) to macro ASC industry topics and trends like evolving payment and care models.


ASCA regularly convenes representatives, including physicians, of all surgical specialties in ASCs to obtain input on the issues that concern them


most so that ASCA’s formal advocacy activities align with physician interests and needs. This is particularly important as ASCA goes about formulating comments in response to the various payment rules it responds to each year.


ASCA has also been active in the electronic health record (EHR) space, bringing together a stakeholder group of more than 100 physicians, vendors, developers, facility administrators and corporate partners to stimulate the proliferation of EHR usage in ASCs. The lack of ASC-specific EHR certification standards prevents physicians from participating in the component of the QPP that can help physicians qualify for positive payment adjustments and, in a larger sense, creates a barrier to the most efficient workflows and transitions of care across settings. Goals of ASCA’s EHR stakeholder group include creating the clinical standards necessary for an EHR certification and the proliferation of EHR technology in ASCs.


ASCA continues to be the only national organization representing ASCs of every specialty on Capitol Hill and remains committed to promoting the interests of all stakeholders that make ASCs a high-quality, low-cost care setting. Physician participation and leadership is crucial to ensuring that ASCs stay on the cutting edge of care delivery.


ASCA regulatory staff is always interested in hearing from physicians who want to become more involved in ASC advocacy or have recommendations for ways that ASCA can improve its efforts to represent ASCs and ASC physicians in Washington, DC, and across the country. Contact Alex Taira at ataira@ascassociation.org.


Study: ASC Colonoscopy Patients Prefer Propofol


Results of a new study published in Diseases of the Colon & Rectum indicate that patients undergoing outpatient colonoscopies prefer propofol over a combination of fentanyl/midazolam as their anesthetic.


To evaluate patient satisfaction with


propofol compared with nonpropofol (fentanyl/midazolam) anesthesia for outpatient colonoscopies, researchers conducted a clinical trial at an Ohio ASC within an urban teaching community health system. During the study, anesthesia personnel administered propofol to half of the patients and


fentanyl/midazolam to the other half. An experienced endoscopist performed all colonoscopies. Patients in the propofol group reported higher satisfaction and fewer complications.


Access the study’s abstract here. ASC PHYSICIAN FOCUS 3


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