Yesterday, the U.S. House of Representatives simultaneously placed another nail in the coffin of hospitals and gave a tremendous boost to ambulatory surgery centers and their physician owners.
That’s because the House passed the 21st Century Cures Act, Medicare legislation that the Senate is expected to pass next week.
The law includes two provisions of the utmost importance to independent ASCs and their physician owners.
Essential Point 1: The Act requires the Department of Health and Human Services to create a searchable web database allowing the public to compare out-of-pocket costs and total expenses for various surgeries at hospital outpatient departments (”HOPDs”) and at ASCs.
Essential Takeaway 1: It’s almost a given that HOPD charges for a procedure exceed those at the ASC setting. Patients will clamor for their procedures to be performed at ASCs.
Essential Point 2: The Act corrects a significant error in existing law pertaining to the use of “certified electronic health record technology,” referred to as CEHRT. Current law requires that physicians use CEHRT for a fixed percentage of patients in order to avoid cuts in Medicare reimbursement. Although current law addresses CEHRT in the hospital and physician office setting, it does not provide for CEHRT in the ASC setting. The Act corrects that error.
Practical Impact 2: The Act removes the disincentive for physicians to perform cases in the ASC setting.
Ultimate Bottom Line for You
1. Patients will have financial information that compels them to have outpatient procedures in ASCs, not HOPDs.
2. Physicians’ incomes will not suffer as a result of performing cases in ASCs as opposed to at hospitals.
3. Hospitals are getting sicker. (Download a complimentary copy of my book, The Impending Death of Hospitals, or, if you’d like it in hard copy, purchase it on Amazon. Physician practices dependent upon hospitals must make strategic decisions, now, for your future.
4. Physicians should immediately investigate whether ASC formation makes sense for you. (We’ve established a strategic alliance with HDA Enterprises, Inc., one of the nation’s most experienced and successful developers and managers of physician-owned outpatient facilities. Contact me immediately if you’d like to arrange for them to provide you with a complimentary initial analysis of how profitable an ASC will be for you.)
Comment or contact me if you’d like to discuss this post.
Mark F. Weiss