ASC Industry Awareness
New ASC Builds and Expansions
Yes, certain areas and states will continue to have their challenges expanding ASCs, Massachusetts being the latest to seek new curbs to their ASC growth ability. Even so, ASCs are showing a significant and varied growth spurt. Patient awareness, cost, safety, and convenience are all aligning to help ASC leaders develop new centers. Andrews ASC is building the first of three planned ASC projects in Northeast Florida. Bronson Outpatient Surgery Center just broke ground on an orthopaedic and sports medicine center in Kalamazoo, Michigan. Bellin Health is planning a surgery center at an old Menards site near Green Bay, Wisconsin. Heartland Surgery Center in Kearney, Nebraska just began a facility expansion to provide greater patient accessibility.
CMS Busy Establishing Rules for 2022
It is the season when CMS finalizes its payment rules for the next year. This has been a particularly busy season for CMS. If you are interested in viewing the final CMS 2022 Medical Payment Rule for HOPDs and ASCs, click here for the fact sheet. Some years, as in 2021, the new rules work in favor of ASCs and some years, such as in 2022, not so much. CMS is removing 255 procedures from the ASC payable list due to a reinstatement of 2020 criteria, which is a more cautious protocol. On November 4, CMS also announced a new emergency regulation to go into effect January 4, 2022, for Covid-19 vaccinations for health care workers nationwide in facilities participating in Medicare and Medicaid programs.
Healthcare Industry/Trends
Challenge and Opportunity in Rural US Healthcare
The challenges in addressing rural health care issues are a tangled web that also provide opportunities for innovation, some of which are starting to make their presence known. Some more rural hospital associations are requesting more federal aid to assist in the challenge and HHS has recently committed not to allow the rural situation to grow worse as telehealth is more readily available. However, our large retailers are making the big innovative moves. Walgreens is making a $5.2 Million investment in VillageMD to bring more primary care to rural America and Dollar General is adding healthcare products to its offerings at its rural stores.
First Ever State Rankings of ASCs per Capita Show Growth and Opportunity
The number of ASCs is growing across the country as patient and payer demand grows. In this first ever ranking of ASCs by state, Maryland leads the pack with 5.54 ASCs per 100,000 population. Vermont is in the back of this pack with .31 ASCs per 100,000 people. So, why is there such a discrepancy of ASC numbers state to state? 14 of 15 states with the fewest ASCs have Certificate of Need (CoN) laws. Some CoN law states do have high proportions of ASCs, but the lack of CoN laws affecting ASCs is a clear benefit for their growth.
Healthcare Digital Transformation Watch
Sustaining the Business of Healthcare Information Technology (HiT)
The global Health IT market, valued at over $75 billion, is expected to grow at a Compound Annual Growth Rate (CAGR) of 10.7% over the next seven years. HiT is a huge market nationally and internationally. EHRs, telehealth, electronic prescribing systems, and clinical information systems all make up large components of the industry. Many healthcare systems, hospitals, and ASCs are making the adjustment from paper to e-signatures. In the EHR world, Cerner is making waves, narrowing its focus. A learning from the pandemic is that interoperability between systems is vital for telehealth to fulfill its potential. Healthcare leaders are finding many and diverse reasons to further their investments in interoperability.
Legal
What to Look for in Health Care in 2022
From the office of Jon Sistare, JD, Attorney at Law
Believe it or not, 2022 is less than 2 months away. A major change to our healthcare billing and payment laws will take effect on January 1 under the No Surprises Act, which had been signed into law in late December, 2020. Some of the rules for this new law are out, but plan for it to be confusing and cumbersome for everyone until things are sorted out.
However, there are some other new healthcare laws that will be upon us in 2022. Next year, the price transparency rule and healthcare provisions in the Biden Administration’s reconciliation bill will go into effect.
Originally, the transparency rule had multiple price disclosure requirements, including a web-based solution that would allow employees to have an Amazon-like experience where they can compare and contrast the cost of care. This would allow an employee to look for a knee replacement and determine what would be the best cost and likely the best outcome. Unfortunately, this provision has been delayed — a large portion of the provisions in the transparency rules has been delayed indefinitely, or has been delayed until July 1, 2023. Because healthcare providers were concerned about their ability to comply with those mandates on a timely basis while still addressing the pandemic, they reached out to the administration and the regulators to request additional time to comply.
In addition to that, there was not complete clarity on all of the mandates with which providers would have to comply. Therefore, providers were seeking additional guidance. The guidance was delayed because of the pandemic as well, which created a little bit of a perfect storm regarding what had to be done by when.
The transparency rules started originally with the Bush administration. The rules continued with the Obama administration and then they obtained additional momentum through the Trump administration. So, it is still significant that a few provisions are going into effect in 2022.
We should anticipate more focus from the new administration on public options solutions. We will see Medicaid expansion in states that have not expanded Medicaid — that’s part of the reconciliation bill, and it is gaining momentum.
Another area that we may see a focus on is pharmacy spending. We have seen the new administration and prior administration consider expanding the ability to purchase prescriptions from Canada, or trying to implement some safety nets to avoid double-digit increases in prescription costs.
At a Glance
CoN Ruling in North Carolina Affects Surgery Center
Kitty Hawk Surgery Center Will Remain Closed
Tens of Millions of Used Medical Gloves Imported to US
Surge in Demand Causes Scramble for Imports
New Jersey Innovation Campus and Large Israeli Hospital Partner
Develop Hospital of the Future Simulation
FedEx, Boeing, Meijer, and Walgreens File Complaint against BCBS
Site Conspiracy to Stifle Competition
Kaiser Permanente Strike Scheduled for Nov. 15 Averted
Up to 35,000 Kaiser Workers Were Prepared to Strike
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