04/13/2016

CASA Holds Annual ASC Summit

Assembly Health Committee Chairperson Jim Wood (D-Healdsburg) Addresses ASC Leaders

The California Ambulatory Surgery Association (CASA) recently hosted its ninth ASC Summit on April 7-8, 2016. The Summit is an invitational gathering of leaders in the California ASC industry. Participants are comprised of National Corporations, “California only” corporations, and single specialty representatives. Leading spokespersons were invited from the major health plans, including Anthem Blue Cross, CIGNA Healthcare, Blue Shield of California, United Health Care, OSCAR and Health Net. The two days were packed with influential speakers, which included California Assembly Health Committee Chairperson, Jim Wood (D-Healdsburg).

_{Bryce Docherty, Howard Krauss MD, Tersa Lech, Peggy Wellman, Assembly Health Committee Chairperson Jim Wood, John Hong MD}

An event highlight, Assembly Member Wood discussed recent activities of the legislature and his expectations as chairperson of the California Assembly Health Committee. His presentation provided good discussion and insightful questions by the audience. Members of the CASA Board were then able to spend some additional time with Assembly Member Wood, discussing trends and impacts the ASC community delivers in providing healthcare for Californians.

New to this year’s Summit, was a discussion around workers’ compensation and the effects since SB 863 took effect in January of 2013. Eric Friedlander, CEO of Starpoint Health, presented on an innovative program being instituted by his ASCs in Southern California. This was followed by a panel that included Robert Mortensen, President of Anthem Workers’ Compensation, and Surgery One CEO, Scott Leggett. They reviewed the trends and concerns the industry is experiencing as a direct impact of the legislation and the change of the physician reimbursement to the RBRVS methodology.

It was also reported that CASA Legislative Advocate, Bryce Docherty, and CASA Executive Director, Beth LaBouyer, met with the California Division of Workers’ Compensation (DWC) Interim Administrative Director, George Parisotto, on April 4, 2016. During the meeting they raised concerns that the DWC Outpatient Surgery Fee schedule has yet to be updated and is still utilizing the Medicare 2014 rates. They also raised concerns over the DWC’s calculation of the county wage index.

The program also contained informative medical presentations from esteemed physicians on moving complex procedures to the ASC environment. Nationally recognized spine surgeon, Sohrab Gollogly, MD, presented on the safety and efficacy of outpatient spine surgery. Kristopher Downing, MD, orthopedic surgeon of San Diego, discussed total shoulder arthroplasty and its migration to the outpatient arena. Orrin Ailloni-Charas, MD, MBA, wrapped it up with the discussion on multi-modal approach to surgical pain management in the ASC.

The second day’s discussion focused on trends in California and opportunities ASCs should be adding to their business model. Kelsey Mellard, Head of Health System Integration at Honor, reported on recent trends concerning CMS bundles and pay for performance. She also highlighted the Honor company which utilizes technology and an innovative approach to provide home care for patients. John Pickett, Head of Network Development for the OSCAR health plan, provided an overview of their unique program and how they integrate technology to provide healthcare coverage for their clients.

The discussion then moved to two very informative panel presentations. Mari Zag, Administrative Director, Providence Health and Services, and Guy Guarige, Director, USCF Medical Group and Physician Services, discussed medical groups taking on financial risks for outpatient surgery.

The final panel of the day addressed the managed, Medi-Cal arena. The panel was moderated by Martin Serota, Senior Vice President and Chief Medical Officer of AltaMed. The remaining panel included Cathy Hughes, Vice President of Provider and Network Strategy for Health Net, Venu Kondle MD, CEO of Nivano Health and Lynn Scuri, MPH, Regional Director, Partnership Health Plan of California.

Dr. Serota opened the discussion with the description of what happened with the ACA and the Medi-Cal expansion focusing on CA. The panel participants then addressed their individual organizations approach to Medi-Cal, including lives covered and trends they are experiencing.

This annual meeting has become a critical component to CASA’s mission of advancing relationships with critical parties for the success of ASCs in California. CASA President, Peggy Wellman, stated that, “She and the CASA Board are very pleased with the outcome of the Summit. The CASA Board will continue to move forward by further establishing relationships with California physician groups, reaching out to large employers on the benefits of ASCs, and continue the ongoing dialogue with the health plans on contracting barriers and the benefits of ASCs to the success of health care reform.”