William Prentice, a seasoned healthcare lobbyist in Washington, became executive director of the Ambulatory Surgery Center Association in Oct. 2010. He shares his thoughts on the need for political activism, ASCs' prospects in the new Congress, efforts to improve Medicare payments and other issues.
Why ASCs should join the association. About half of the nation's ASCs are members of the association, and Mr. Prentice would like to see the other half join. "We need everybody's input, not just in dues enrollment but also in intellectual capital and grassroots activities, such as contacting members of Congress," he says. He likens joining the ASC Association to taking out an insurance policy. "It insures that someone is out there advocating for you on your behalf, that someone is protecting you from outside forces that do not have your interests at heart," Mr. Prentice says. "If everyone is working together, we can be stronger."
New cost-consciousness in Washington. "We're going into a period of divided government," Mr. Prentice says, "but in both parties there is a sense that 'the bill has come due,' that government spending has got to be brought under control." He believes this viewpoint will affect every decision made in the nation's capital. "You're going to see very little happening," he says, "without being predicated upon the question, 'Where are we going to find the money for this?' "
How ASCs' interests will fare. Mr. Prentice thinks surgery centers fit well into the new cost-consciousness because they are the low-cost, high-quality choice. "We have a good story to tell about the ASC industry," he says. Since ASCs' costs are so much lower than those of hospital outpatient departments, he thinks the association has a strong case for a rate increase. "We'd like to see the payment gap between ASCs and HOPDs close," he says. "Ambulatory surgery centers cannot be expected to continue to provide the excellent service they do without being compensated fairly for it."
Plans to reintroduce payment bill. Last year, the association introduced a bill to change the payment methodology for ASCs. The bill would end tying ASC payments to the Consumer Price Index, which has no relation to ASC costs, and tie them instead to the hospital market basket. The association plans to reintroduce a similar bill this year. "We are looking for sponsors," Mr. Prentice says. "We have a number of strong advocates for ASCs in Congress." In August, for example, a letter asking CMS to fix the ASC reimbursement update was signed by more than 20 U.S. senators, more than double the number who signed a similar letter in 2009.
Demonstrating ASC Quality. Through the ASC Quality Collaboration, many surgery centers have been voluntarily reporting quality measures endorsed by the National Quality Forum. The aim is to have enough data so that a valid measure of actual infection rates can be determined and then use it to compare with data on similar healthcare settings. Since 2006, CMS has had the power to require ASC quality reporting. It has been holding off, but now it is expected to implement the reporting by the end of the year, Mr. Prentice says. "ASCs provide top-notch quality of care," he says. "We want everyone to know about that."
Number of inspections may decline. The number of Medicare inspections of ASCs has been increasing due to extra funding from the federal stimulus bill, but that extra funding is about to expire. With no new source of funding identified, "we don't know if surveys will continue at the same rate," Mr. Prentice says. Also, surgery centers have been telling the association they are concerned surveys are not being implemented in a consistent manner. "We want to work with CMS to make sure there is consistency in the surveys," Mr. Prentice says.
Role of ACOs. Mr. Prentice believes accountable care organizations might well play a large role in the next few years, but at this point, "they are still a theoretical," he says. "How many ACOs will actually materialize is an open question." Everyone is waiting for CMS to release proposed regulations for ACOs, expected this month.
Aims for the future. "We can always do a better job engaging our centers in federal advocacy," Mr. Prentice says. "We will never have the sheer numbers of staff or money that other groups might have, but we can still be very successful if we all work together and maximize the advocacy of this industry as much as possible."
Learn more about the ASC Association.
Read more from the ASC Association:
- ASC Association Announces 2011 National ASC Open House Day
- Medicare Clarifies Same-Day History and Physical Guidance for Surgery Centers
- 5 Reasons for ASCs to Be Optimistic About 2011