February 15, 2019

Industry Awareness

Growth in the ASC Market

2019 is expected to be what 2018 certainly proved to be: an excellent year for ASC growth. That growth continues internationally and nationally, with North America still accounting for just under 60% of all ASCs. This list of 21 new ASCs in January demonstrates the power of ASCs in today’s marketplace. Solid growth has mainly been driven by two factors: technological advances that have shifted more surgeries to outpatient settings and the cost-effectiveness of ASCs in comparison with hospitals. Technological advances in cardiac procedures are likely to make them the total joint replacement surgeries of tomorrow for ASCs.


More Competition Means More Comparison Tools

Increasing competition in the medical marketplace and the increasing awareness of ASCs is resulting in more attention being placed on comparison tools. Medicare patients can compare costs for outpatient surgeries on a new site – at least theoretically. In practice, there are several reasons such comparisons are still challenged. As ASCs increase in popularity, patients are being encouraged to raise comparison questions so they are thoroughly prepared for their outpatient surgeries. Leapfrog is now including all ASCs nationwide in its survey this year, which compares healthcare providers on issues of safety and quality. Together, these tools demonstrate the practical reality that we’re all becoming more informed medical consumers with increasing awareness of our healthcare spending.



Patients as Consumer Driving Provider Changes

Since patients are being consistently confronted with the need to take more ownership of their healthcare and their healthcare finances, providers are seeing the need to shift to keep up with those transformations. Patients are becoming medical consumers. Medical consumers have real choices. Consumer choice means that providers have to consider how to drive patient consumer loyalty. A new Johnson & Johnson white paper on the subject states that 60% of the of the top 10 loyalty drivers are related to patient experience rather than cost or quality. Great patient experiences are linked to customer retention and to improved health outcomes. Patients are desiring a more customer-friendly experience.


Price Transparency More Widely Embraced

As of January 1, 2019, hospitals are required, by a 2018 CMS rule, to post their standard charges online. This is in attempt to create a more patient-centered healthcare system by driving greater price transparency. CMS is putting teeth into the ruling through its creation of the “#Where’s the Price” Challenge, which encourages consumers to pass on information about non-complying hospitals. Consumer attempts to obtain price transparency are still fraught with obstacles since pricing structures, insurer contracts, and variations in service make full transparency somewhat mythological in all states but New Hampshire, where significant price transparency has existed for over a decade.


Revenue Cycle

Connection between Health Spending and Revenue Cycle Management

For many reasons, financial worries keep hospital CEOs up at night – shifting regulations, bad debt, and the cost of demonstrating compliance among them. However, as health spending for US workers with job-sponsored insurance hits an all-time high, all providers are pressed to consider another cause of financial concern — the critical capability of revenue cycle management, which can be nettlesome to maintain at sufficient levels.



Cybersecurity, HIPAA, and Protected Health Information

by Laura Raymond, Contego Paralegal, from the office Jon Sistare, JD, Contego Attorney

Late last year, Marriott International, Inc. revealed that a breach of their data security system compromised the personal data of hundreds of millions of guests. While this episode should be alarming to any business holding sensitive client data, it should be especially worrisome to health care providers, who hold arguably the most sensitive data of all: personal health information (PHI).

Although every healthcare provider should already have a HIPAA-compliant system in place for monitoring and safeguarding PHI, it’s a good idea for providers to proactively evaluate and update their processes on a regular basis, especially in this age of increased cyberattacks. Especially important to put into place is a procedure for minimizing the impact of a breach once it has occurred. As electronic medical record management continues to grow, the chance that providers could inadvertently disclose the wrong PHI likewise increases; one wrong click or one incorrect letter in an email address could result in a breach. Perhaps the biggest source of risk comes from the use of third-party vendors, such as records managers, payment processors, and financial and administrative contractors.

Thankfully, most of the risk of a potential breach can be mitigated through proactive preparations. Providers should identify any aspects of their business that might be susceptible to a breach, including not only software systems but also patient access to sensitive areas and disgruntled employees. They should also establish HIPAA-compliant agreements with any outside vendors, and carefully govern exactly what data said vendors have access to. Providers should have a plan in place to identify breaches as soon as possible after they occur, and a procedure already established to remedy any sort of anticipated breach. Lastly, as part of their liability insurance policies, providers should ask their insurance agents about a cyber risk protection policy.


At a Glance

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