This Week – July 28, 2018
This Week in Washington, D.C.
- New! ACG Practice Management Toolbox Articles: Physician & Provider Wellness, and Team Based Care
- Tri-Society Alert: OPPS/ASC Proposed Rule Updates ASC Payment Using Hospital Market Basket
- Call to Action: Urge the Senate to support the Ambulatory Surgical Center Payment Transparency Act of 2018!
New this week to the ACG Practice Management Toolbox are two articles brought to you by Stephen J. Utts, MD, MHCDS, FACP, FACG of Austin Gastroenterology and the ACG Professionalism Committee, addressing some pertinent topics in the Wellness category. Physician burnout is an “emerging crisis in healthcare,” and in “Physician & Provider Wellness” and “Team Based Care,” practical suggestions for avoiding burnout, increasing care coordination in your practice, and testimonials from members of the Professionalism Committee are provided and outlined in detail. Tending to you and your team’s overall psychological well-being not only has a positive effect on your psyche and productivity, but ultimately, allows you to better provide the necessary care and attention to your patients.
What is the Practice Management toolbox?
Gastroenterologists in private practice find themselves working in a time of unprecedented transformation. Pressures are high as they make important management decisions that profoundly affect their business future, their private lives, and their ability to provide care to patients. The ACG Practice Management Committee has a mission to bring practicing colleagues together to explore solutions to overcome management challenges, to improve operations, enhance productivity, and support physician leadership. It was in this spirit that the Practice Management Toolbox was created.
The Toolbox is a series of short articles, written by practicing gastroenterologists, that provide members with easily accessible information to improve their practices. Each article covers an issue important to private practice gastroenterologists and physician-lead clinical practices. They include a brief introduction, a topic overview, specific suggestions, helpful examples and a list of resources or references. Each month a new edition of the Toolbox will be released and will then remain available here along with all previous editions. The Practice Management Committee is confident this series will a provide valuable resource for members striving to optimize their practices.
OPPS/ASC Proposed Rule Updates ASC Payment Using Hospital Market Basket
Late Wednesday, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2019 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Centers (ASCs) Payment System proposed rule. Like the Medicare Physician Fee Schedule (PFS) proposed rule released earlier this month, the administration continues to look for opportunities to decrease administrative burden for the health care system while making patient-centered care a priority. The ACG, AGA and ASGE are currently reviewing the details of the proposed rule.
The OPPS and ASC proposed rule will appear in the Federal Register on July 31. The deadline to submit comments to CMS is Sept. 24, 2018. The rule can be downloaded here.
This communication offers a topline summary of the proposed changes to the payment rates and policies for Medicare services paid under the Medicare OPPS/ASC.
- ASC inflationary update: After over a decade of advocacy by the GI societies and other stakeholder organizations, CMS is proposing to update ASC payment rates using the hospital market basket rather than the consumer price index-urban (CPI-U) for 2019-2023. The GI societies support payment adequacy by site of service. In the proposed rule, CMS states that this change will help to promote site-neutrality between hospitals and ASCs and will encourage the migration of services from the hospital setting to the lower cost ASC setting. We applaud the change in the update and will continue to advocate for adequate payment based on site of service.
- ASC conversion factor: CMS proposes a CY 2019 conversion factor of $46.50, an adjusted update factor of 2.0 percent. Click here to access proposed ASC payment rates for GI services.
- OPPS update: For CY 2019, CMS proposes a conversion factor of $79.54, a 1.25 percent increase over of CY 2018. Click here to access proposed OPPS payment rates for GI services.
Call to Action:
Urge the Senate to support the Ambulatory Surgical Center Payment Transparency Act of 2018!
Great news! Earlier this week, the “Ambulatory Surgical Center Payment Transparency Act of 2018 (HR. 6138)” passed the U.S. House. This bill, introduced by Rep. Devin Nunes (R-CA-22), requires CMS to specify the criteria used when Medicare excludes procedures from the list of covered surgical procedures that may be performed in an Ambulatory Surgery Center (ASC). The CMS may not exclude a procedure on the basis that the procedure can only be reported using an unlisted surgical procedure code. The bill also requires the advisory panels reviewing the Medicare prospective payment system for hospital outpatient department services to include at least one ASC representative.
In order to continue this budding momentum as it makes its way towards the Senate, we need your help. Click below to reach out to your Senators and urge them to get behind this important issue!