Outpatient Surgery Magazine

Obamacare, You're Fired - December 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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how a patient was comparison-shopping for his inguinal hernia repair. The local hospital quoted the patient a price of $25,000. The surgery center's bundled price was $4,900, less than one-fifth the hospital's. Where do you think the patient went? The ASC-HOPD dynamic was also in play in Potsdam, N.Y., where a hospital planned to open an ASC. As an off-site, hospital-owned ASC, Medicare would reimburse it at the higher hospital rate. But a few months after Canton-Potsdam Hospital poured the foundation for its new surgical facility, Medicare passed its so-called "site-neutrality law," which pays newly built or acquired HOPDs that are located 250 yards or more from the hospital's main campus as it does freestanding ASCs. Yes, that would be half. The site of the new facility is about 10 miles from the main hospital, where today it sits as an empty shell. The hospital says getting paid as an ASC would have been "financially difficult." CMS says site neutrality could save Medicare about $500 million in 2017. Jay Horowitz, CRNA, our longtime friend and editorial board member, is pretty sure he's come up with a way for President-elect Trump to save $20 billion: stop paying for medical direction of certified registered nurse anesthetists. "One anesthetic, one provider, one payment. Period," he says. Even though CRNAs can practice independently without physician supervision in many states and no state requires supervision by an anes- thesiologist, anesthesiologists can bill for medically directing as many as 4 CRNAs. Mr. Horowitz did the math and says that removing payment for medical direction would save $20 billion. "A damn fine way to start your first day in office." OSM D E C E M B E R 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 9

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