In the News: Jul 12–19

HHS Proposes Database to Track Patient Safety at ASCs

A recent Modern Healthcare article describes HHS oversight efforts to launch a patient safety database for ambulatory surgery centers (ASCs). According to federal data, the number of ASCs grew at an average annual rate of 1.3% from 2011 to 2016.

As the number of ASCs has grown, the service offerings have grown as well, which has prompted the attention of federal regulators. HHS’s Agency for Healthcare Research and Quality will develop quality measures to track adverse health reactions with data collected from a patient safety culture survey administered to ASC staffers. Support for this initiative is varied, with opponents questioning the utility of data collection if not accompanied by action.

Given that ASCs excel at standardizing procedures, cutting costs and maximizing operating room efficiencies, this site of care serves a vital role in many organizations’ shift to value-based care. Sg2 encourages its members to evaluate trends in ASC growth as a key component to their long-term strategy. To learn more about ASC growth opportunities, case mix and reimbursement policies, read the Sg2 FAQ Migrating Surgical Procedures to ASCs.

Physician Perspectives of MIPS in Year 1 of MACRA

A recent Health Affairs study surveyed a sample of 1,431 internal medicine physicians to understand their beliefs about the Merit-based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA). Over half of the responding physicians reported “some” or “a great deal” of willingness to change their behavior in 4 focus areas: reporting and performing well on clinical quality measures (53%), initiating or participating in clinical practice improvement activities (59%), controlling patients’ use of resources (58%), and implementing and using electronic health records (58%).

Furthermore, 60% of responding physicians reported being “not at all familiar or only slightly familiar with MACRA and its requirements,” while only 8% are very familiar, suggesting that while over half of physicians believe that the 4 MIPS domains would ultimately improve the value of care, there is a need to educate physicians about MIPS requirements.

MIPS is a complicated program containing countless scenarios and moving pieces, with time and resource investments often out of reach for many practices. Sg2 believes that health systems can use MIPS as an opportunity to communicate, align and support employed physicians and independent practices. For more on short-term tactics and long-term strategies for MACRA success, read the Sg2 Expert Insight Solving the MACRA Puzzle: Short-term Tactics and Long-term Strategies.

The Growing Role of Private Equity in Health Care

A recent Crain’s Chicago Business article explored the growing role of private equity in health care, which has experienced increased investor attention due to high fragmentation and growth potential. Views on whether third-party investment in physician practices and other low-acuity sites of care can result in quality improvement and lower prices differ. The American Medical Association is currently facing a yearlong effort to quantify the impact of private equity on the way doctors treat their patients.

The article highlights an Accenture study that found the share of US doctors in independent practice was 33% in 2016, down from 57% in 2000. One expert asserts that “The uncertainty over health care policy in Washington is probably driving the integrated health care delivery systems and large hospitals to bulk up almost as a counterweight to the uncertainty they face. They know that if you are bigger, you are in a better position to survive whatever may come your way.”

The recent explosion in nontraditional mergers and acquisitions (M&A) has targeted opportunities at lower-acuity, less expensive sites of care. Sg2 believes that if disrupters begin to compete for patients in primary and post-acute care, health systems could lose significant revenue from these and other downstream services. For more on these threats to the Systems of CARE, read the Sg2 Expert Insight Vertical M&A in Health Care: What Does It Mean for Health Systems?

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