Ambulatory Surgery Centers

Ambulatory surgery centers struggle in NJ, around the country

Anne Zieger — Tue, 25 Nov 2008 09:31:56 -0500

There are nearly 5,000 ambulatory surgery centers around the country, but some face more challenges based on the state in which they are located. Tensions ebb and flow between hospital-owned and physician-owned centers, and if an ASC is located in a state where tensions have peaked, like New Jersey, the centers can be in big trouble. Article

PA bill would end required overtime by health workers

Anne Zieger — Thu, 09 Oct 2008 12:48:07 -0400

A new bill working its way through the Pennsylvania legislature would ban the state's hospitals, ambulatory surgery centers and long-term-care providers from demanding nurses and other clinical workers to work overtime.

The bill, which has passed both chambers of the state's legislature, includes clinical workers who aren't considered supervisors in union contracts, and those who earn hourly wages and those who are temporary workers. On the other hand, it excludes doctors, physician assistants and dentists, as well as other jobs not directly related to care such as clerical and maintenance functions.

The rules aren't without exceptions, included to mollify the Hospital & Healthsystem Association of Pennsylvania. The measure includes language which allows healthcare employers to require overtime under certain specific circumstances, including unforeseeable declared emergencies, unforeseen or extraordinary events (read disasters, terrorism or the like) that impact their staffing needs or big vacancies that substantially affect patient safety. (The bill specifically notes that chronic short-staffing won't cut it as an excuse for mandating overtime.)

To learn more about this bill:
- read this Modern Healthcare article (reg. req.)

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MedPAC mulls financial relationship disclosure rules

Anne Zieger — Sun, 05 Oct 2008 19:11:16 -0400

The Medicare Payment Advisory Commission (MedPAC) has started considering recommendations that would require new disclosures regarding financial relationships between drug manufacturers, device makers, physicians and other providers. The recommendations are a sign of the times, as they come on the heels of a growing series of legal decisions, regulations and laws expanding such disclosure rules.

One recommendation would establish a new federal law requiring all makers of drugs, biologicals, medical devices and suppliers, and their subsidiaries to submit data on their financial relationships with various providers. That would include physicians and other prescribers, hospitals and medical schools, professional and patient-safety groups and organizations sponsoring CME programs.

Other proposed recommendations would require hospitals and ambulatory surgery centers to report every year on each physician who directly or indirectly owns an interest in an ASC. Also, HHS would submit a report on the prevalence of financial relationships between hospitals and physicians.

To learn more about MedPAC's ideas:
- read this Modern Healthcare piece (reg. req.)

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NJ hospitals in dire straits after charity budget cuts

Anne Zieger — Wed, 09 Jul 2008 10:37:45 -0400

While hospitals in every state are struggling to fund charity care and bad debt, things in New Jersey are particularly bad. Not only does the state have 1.3 million people without insurance--and a law in place requiring hospitals to treat anyone who visits--but also, the state now faces major cuts in the funding that paid for these impoverished patients. Gov. Jon Corzine (D) recently signed a state budget that cut $111 million from the charity care fund. Now, hospitals that were already struggling are facing even worse problems.

Hospitals say that the stage was set for the hospitals' financial weakness well before the charity cuts, in part due to patients cherry-picking from ambulatory surgery centers. Now, with half of the state's hospitals operating in the red, observers and hospital leaders expect to see many more closures.

These closures are particularly likely to occur in communities populated by high numbers of poor patients--the ones who will find it most difficult to transfer to another hospital. For example, Plainsfield, NJ-based Muhlenberg Regional Medical Center--which serves a poor, ethnically-mixed community--has begun the process of closing down its acute care beds after operating continuously for 130 years. It lost $16.8 million last year and expects to lose another $18 million in 2008.

To learn about the hospitals' troubles:
- read this Washington Post piece

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New Hampshire rolls out hand-washing program

Wed, 30 Apr 2008 06:59:55 -0400

New Hampshire's Commission of Healthcare Quality Assurance has rolled a campaign intended to foster safe hand-washing practices in hospitals and ambulatory surgery centers. The program, which is based on guidelines prepared by the CDC, has set 100 percent hand-washing compliance as its goal, and requires leaders of healthcare organizations to make a commitment to achieving this goal. Features of the program include making hand hygiene supplies accessible, offering hand hygiene training to staff and testing them on competency. The program also measures hand hygiene compliance and provides healthcare leaders with feedback on how their institution is doing on these measures.

To learn more about the program:
- visit the "High Five" site

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Trend: Medical prices set to jump again

Tue, 22 Apr 2008 06:59:57 -0400

While medical prices fell for the fourth consecutive year in 2007, observers say that health costs likely will shoot up again, soon. According to an article in the journal Health Affairs by author Paul Ginsburg of the Center for Studying Health System Change, there are several factors contributing to the coming jump in prices, including a hospital's need to cover the cost of their tremendous recent investments in new buildings; the growth in physician ownership of ambulatory surgery centers and specialty clinics, which Ginsburg says has historically driven up prices; and a shift in the overall U.S. economic cycle. Such price increases could drastically hike health insurance premiums. Even with health cost increases having been moderate over the last few years, health insurance premiums still have risen 78 percent since 2001.

To learn more about this trend:
- read this article from The Oregonian

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ALSO NOTED: Minn. health plans lose money; ASCs struggle with EMRs; and much more...

Fri, 18 Apr 2008 06:59:50 -0400

> Minnesota health plans lost money last year, which suggests that premiums will rise faster in coming years. Article

> A new study suggests that ambulatory surgery centers are facing big obstacles in implementing electronic medical records. FierceHealthIT

> Hospitals could actually make good on many more of their self-pay accounts, researchers say. FierceHealthFinance

> Advertisements for psych drugs in medical journals are often misleading, with half the claims made offering no backup, according to a new study. FiercePharma

And Finally... Whew. Glad we got this one sorted out. Article

SPOTLIGHT: Georgia revamping CON, ASC rules

Thu, 10 Apr 2008 06:59:52 -0400

The deed is done. Georgia has officially passed a new law that not only streamline's the state's CON program, but also allows general surgeons to open ambulatory surgery centers without prior approval. The Georgia Hospital Association, whose members aren't thrilled by the prospect of new competition, previously had filed a lawsuit opposing the changes allowing the new ASCs.
Article

GA may approve sweeping CON changes

Wed, 02 Apr 2008 07:59:56 -0400

Georgia seems well on its way to approving a new bill that would remove most of the state's Certificate of Need restrictions. The state House of Representatives is considering a measure, championed by a few legislators, which would help general surgeons open ambulatory surgery centers. It also would let hospitals build parking decks and other non-clinical projects without state permission and lift obstetrics restrictions on some hospitals, as well as allowing more hospitals to perform heart procedures like diagnostic catheterizations. If passed, the bill would institute the biggest changes in the CON system since it was enacted more than 25 years ago.

Despite gifts to the hospital industry, some hospital officials remain in opposition. They're uncomfortable with a few facets of the bill, particularly the ambulatory surgery changes. Their lobbyists argue that the bill would give the ASCs an unfair advantage. Other hospital groups, including rural hospitals, are in favor of its passage.

To learn more about the CON changes:
- read this Atlanta Journal-Constitution piece

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