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Amy Jones - Best Practices for Managing Your Medication Room
119 Plays2 years ago
Managing a medication room in a surgery center can be super complicated. From vendor selection to national drug shortages to supply chain issues to drug diversion it can be extremely overwhelming. Amy Jones, Owner of Jones Premier Pharmacy Consulting, joins us today to discuss the policies ASCs should put into place so that they can have full control over their medication room.
In our news recap, we'll cover a new price transparency law impacting Virginia ASCs, declining physicians pay, the latest industry acquisition, and over-the-counter hearing aids.
Articles Mentioned:
VA ASCs to Be Included in Implementation of State’s Hospital Price Transparency Law
How declining pay is pushing physicians to ASCs
National Medical Billing Services Announces Acquisition of MedTek
The Biden Move to Allow Hearing Aids to Be Sold Over-the-Counter is Now Saving Americans Thousands
Brought to you by HST Pathways.
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Transcript
Podcast Introduction
00:00:01
Speaker
Welcome to This Week in Surgery Centers. If you're in the ASC industry, then you're in the right place. Every week, we'll start the episode off by sharing an interesting conversation we had with our featured guests, and then we'll close the episode by recapping the latest news impacting surgery centers. We're excited to share with you what we have, so let's get started and see what the industry's been up to.
00:00:28
Speaker
Hi, everyone.
Medication Management Challenges in ASCs
00:00:29
Speaker
Here's what you can expect on today's episode. We are talking with Amy Jones, owner of Jones Premier Pharmacy Consulting, all about managing your med room.
00:00:39
Speaker
Amy shares with us common mistakes, how to choose vendors, overcoming med shortages and supply chain issues, and so much more about how you can have full control over your bedroom and know exactly what's coming in and what's going out. We'll close the episode with a few news stories.
Virginia's Price Transparency Law
00:00:56
Speaker
We'll start with the new price transparency law in Virginia.
00:00:59
Speaker
Talk about how declining pay is pushing more and more physicians to ASCs, look at the latest industry acquisition, and of course, end the new segment with a positive story about a recent executive order that will allow hearing aids to be sold over the counter. Hope everyone enjoys the episode and here's what's going on this week in Surgery Centers.
00:01:27
Speaker
Awesome. All right. How's it going, everyone? I am your host here at This Week in Surgery Center's Raffaele Kinspie, and this week we have an amazing episode. I am super excited for this one. We've had this on our calendar for a bit, so excited to jump in here.
Introducing Amy Jones
00:01:43
Speaker
We are joined today by Amy Jones of the Jones Premier Pharmacy Consulting Group. She's got some amazing insights, and today we're actually going to be walking through a really cool topic around the best practices for managing your med room.
00:01:57
Speaker
So Amy's got a ton of years of expertise and knowledge on this, but I couldn't do her introduction justice. So Amy, I'm going to turn it over to you for anyone who hasn't heard of you or doesn't know about your consulting practice. Can you just share a little about yourself and kind of what, what you guys offer? Yes. Thank you. Thank you for including me in this, uh, surgery center broadcast. Uh, my name is Amy Jones and.
00:02:24
Speaker
As Raphael mentioned, the company is Jones Premier Pharmacy Consulting, and I handle, you can kind of think of any medication management related items. So traditionally it has been for surgery centers or ASCs, but also includes freestanding emergency rooms, micro hospitals, as well as hazardous medication consulting, sterile compounding consulting, and that can range from
00:02:50
Speaker
physician clinics, ASCs, even smaller hospitals that need assistance with their medication practices. Awesome. That's fantastic. And I know you've been in this space for a while. How long have you been in this consulting space and kind of what inspired you to get started here?
Amy Jones' Pharmacy Consulting Journey
00:03:12
Speaker
Yes, so I've been a pharmacist for 17 years now. The time has flown whenever I say that number. And I started consulting in 2009 and then started my own business in 2016. I realized that I enjoyed, had a passion for assisting facilities with their medication
00:03:34
Speaker
processes, whether it's everything from the architecture and design of the med rooms and med storage places throughout the facility licensing, facility licensing, DEA licensing, and then regulatory compliance. And then especially, you know, just choosing their medication formulary.
00:03:55
Speaker
as well as what is the organizational structure that they will use for nursing physicians to order, administer, and document their medications.
00:04:08
Speaker
Awesome. Well, that's one, some really great background. Seems like you've got years of expertise there that are going to be super insightful for our guests, or excuse me, for our listeners. As we kind of jump into it, thinking about this, there are a lot of topics we wanted to cover with you, but today we'll just focus on the best practices for managing your medication room in an ASC.
00:04:31
Speaker
I think this is an area that's pretty common for a lot of our listeners out there in terms of the opportunities within their medication room. But for you as someone who's worked with so many different surgery centers, what are kind of the top three common mistakes that you see in terms of how surgery centers manage their medication rooms?
Common Mistakes in Medication Management
00:04:52
Speaker
Yes, yes, I think that's an important topic. I would say I would categorize them in three sections. One is determining a medication process. Two is having dedicated staff. So either that's having a consultant pharmacist on board, having a dedicated nurse to the process, and then following standard protocols. So I'll dive deeper into each of those three. So for medication processes,
00:05:19
Speaker
It's determining a standard way of getting the surgeon orders or the surgeon preferences for cases prior to the schedule, knowing what those medications would be, and also being able to
00:05:37
Speaker
troubleshoot if that's not a medication that's normally on their formulary or has very complicated administration practices and being able to hash that out before the case is scheduled.
Standardizing Medication Orders
00:05:52
Speaker
That also will reduce the amount of high dollar, what we call non-formulary medications
00:05:59
Speaker
being requested for cases if you have a pretty structured way of getting those surgeon orders, knowing what those medications will be ahead of time, and troubleshooting that, let's say several days before the case.
00:06:15
Speaker
Other things that happen is just being able to list what your formulary is ahead of time. So the expectations are clear on both ends, right? Surgeons that are scheduling cases at the facility, as well as the nursing staff, if they get questions for an add-on case or any type of new surgeon coming on board.
00:06:38
Speaker
They will have an idea, okay, this is a medication we have never had to use before. Is this something we are going to carry? Is this something that's feasible administration-wise for our facility to do, right? There are medications that can be really complicated where they're frozen. They have to be defrosted in a certain period of time.
00:07:01
Speaker
then they have to be put in a certain applicator before administered. And so those would be situations where you as a facility, if you are going to go that route, at least you plan ahead, do nursing education, and know before the day of the procedure. Because what can happen if those are not in place is what
00:07:22
Speaker
You kind of have a more stressful environment where errors can be made, right? So maybe the wrong medication is ordered, the wrong dose is ordered, or it's prepared incorrectly and puts the patient at risk because we're trying to do that very quickly with items that are unknown. That makes sense.
Need for Dedicated Medication Management Staff
00:07:46
Speaker
Yeah, so the second item that, you know, I see many mistakes with is having dedicated staff. So if there are some surgery centers in the US that do not have a consultant pharmacist. And so one of the suggestions that you'll hear me talk about throughout this would be to have a consultant pharmacist, maybe even if your state board of pharmacy rules don't require it.
00:08:11
Speaker
or your Department of Health doesn't require it, to work out some sort of procedure where you have a consultant on board that can help you with these decisions that we're gonna go through throughout this podcast. At the very minimum, having a dedicated nurse, so if there's not someone that volunteers to kind of handle the medication processes in the med room,
00:08:40
Speaker
trying to get someone assigned to that area. The reason why I say that as a mistake is what can happen is folks don't realize how time consuming the medication process can be for surgery centers and other facilities. And so if there's no one really assigned, no one really takes ownership of that area. So you have
00:09:04
Speaker
things that are not ordered, you don't have an organized process of where the medications go in the med room, you don't have an organized process of documentation, and then also just follow up. Let's say a medication is a multi-dose vial and you can use additional doses, is somebody making sure those things are getting, those vials are getting dated and that they're stored appropriately so that it can be used.
00:09:33
Speaker
safely for the other doses. Awesome.
Importance of Standard Protocols
00:09:38
Speaker
Awesome. And then the third item in that same question of the common mistakes would be having standard protocols. Standard protocols and what we call order sets or standard orders, this has been integrated into healthcare for many decades now. But what I see is sometimes ASCs do not have them in place.
00:10:03
Speaker
So having structured standard orders or standard protocols where the nursing staff can all be educated, anesthesia staff can all be educated and know what those are. So examples would be your preoperative antibiotic dosing, having a structured weight-based dosing and the type of antibiotics you use for which cases.
00:10:31
Speaker
And then if these cases are a long case, they will actually have to give additional doses of antibiotics in the case. And many times that is not written down. There's not a protocol in place. And so patients may not get those additional doses for very long surgical cases. And now you potentially have put them at risk for not giving them additional dose.
00:11:00
Speaker
Yeah, so again, this is something that I see regularly and can easily be addressed ahead of time. Another standard protocol that I haven't seen in full practice in ASCs is multimodal pain management. That has been put into place in many of our hospital systems, but in your surgery centers, I have not seen that routinely in place.
00:11:28
Speaker
So what I mean by that is having a structured, giving patients pain medication that's not just your opioids, that we can give multimodal, giving them your Tylenols or your NSAIDs, which is ibuprofen or maybe Celebrex, prior to surgical procedures so that we can reduce the amount of
00:11:55
Speaker
opioid analgesics that we give patients after the surgery or even maybe not having to prescribe those when they're leaving the surgery center. That makes a ton of sense. And I think you nailed kind of a number of things there that happened directly within a surgery center that with the right protocols and kind of structures around the team, you're able to manage. One of the things that kind of comes to mind as a part of that is thinking about
00:12:23
Speaker
some of the elements of what kind of happens outside of the surgery center in terms of kind of vendor selection. What are some of the recommendations that you have around kind of vendor selection and like ways that ASCs can approach that?
Vendor Selection for Medication Supply
00:12:38
Speaker
Sure. Yeah, that's a great question. And I think that is something even for established ASCs that can come up as a point, especially if they have not had a consultant pharmacist in place.
00:12:51
Speaker
But for your newer ASCs, determining a vendor, all vendors are not created equal. Some vendors are focused more on your supply chain, so your needles, your syringes, IV tubing, et cetera. And then you have vendors that do have a pharmaceutical division, and that is one of their major divisions.
00:13:15
Speaker
of that company. So you want to look for those vendors and even if what I commonly see is you have an ASC that's just opening up.
00:13:26
Speaker
And they're not doing many cases at that time because they're still waiting for either CMS certification or any of their other regulatory certifications. And they have been able to get by with the vendor that they chose. But that vendor doesn't have a strong pharmaceutical division. So then when they start to do more and more cases,
00:13:49
Speaker
they realize that that vendor is not able to keep up with the medication supply. So what I always try to choose is a vendor that has a large pharmaceutical division and is able to keep up with the drug supply, especially with the amount of drug shortages that are out there. You definitely want them to have a large warehouse or multiple warehouses across the country and just be aware of that. Some other items to think about is
00:14:19
Speaker
in that initial contract, what is going to be the delivery process? Some vendors will actually restrict you to one delivery day a week, which can get really tricky as you get busier, right? So as you add on cases, there's going to be things that come up where you need additional medications. And if your vendor is only one day a week, that's going to put you
00:14:46
Speaker
you know, in a situation where you're gonna have to pay additional fees to get an additional delivery. So maybe negotiate at the beginning to have a multiple day a week delivery schedule to account for the volume that you plan on having at your surgery center.
00:15:05
Speaker
That makes a ton of sense there. And you know, in terms of just kind of that vendor piece, you know, you mentioned a couple things around kind of the supply factors and their ability to meet the supply needs. And I know we've probably all been hearing a ton in that regard in terms of kind of things that have happened during kind of the COVID and the pandemic in terms of impact on supply chain. But you know, based on just some of the things you mentioned there, it seems like supply and kind of managing and
00:15:30
Speaker
preparing ahead for any potential shortages is something that seemed like even past COVID or even before COVID was a factor that was important.
Causes and Impact of Drug Shortages
00:15:39
Speaker
Are there any insights or background you can share there in terms of just how centers should be thinking about managing for shortages or how those different shortages can impact a center? Sure. Just to explain a little bit about why
00:15:57
Speaker
drug shortages exist, there are multiple factors. And I think that it's worth describing because there are some misconceptions about why drug shortages exist. So just with anything, right, if you're having a computer made or a car made, there's multiple pieces to that production. And I think that there are misconceptions that that all happens in one place, right, like
00:16:23
Speaker
one plant in the United States. But it doesn't. With drug supply, what happens is they will have pharmaceutical companies will have plants throughout the world. And each of those plants may provide a different portion of that production. So you may have a plant in India that's making the actual product ingredient or the powder of the drug which we refer to as API.
00:16:51
Speaker
And if that plant has some issues, whether they were shut down or had all their staff out for COVID or whatever it is, you don't have the actual powder to finish the production. So maybe your other plants are doing fine, but you don't have the initial product. And then your glass vials may be made at a different plant that may all be brought together at one plant and then they prepare the final product.
00:17:21
Speaker
And so if one of those plants goes down, it can cause a problem or delay. Some other things that can cause a delay would be if that plant is inspected by FDA and the FDA finds some concerns there. And they can be inspected by the FDA in other countries as well. I think people don't realize that. But if a product is being used in the United States, the FDA,
00:17:48
Speaker
or I'm sure they send a representative to go into another country's plant and do that inspection. So if the FDA determines that they're concerned, whether it's in documentation or their production process or contaminants, the FDA can actually shut that plant down. And so that would cause, mm-hmm. And that's very frequently what you see is you have a pharmaceutical company
00:18:18
Speaker
who produces, let's give, we're gonna give lidocaine as an example because lidocaine is on shortage right now. But let's say that plant is the only plant that produces lidocaine and the FDA comes in and says, we don't agree with your documentation. You're not taking enough samples or these samples appear to be contaminated. They will shut that plant down until they
00:18:45
Speaker
Sea resolution in whatever the issue is that the FDA has found well now that company is Left spinning right because that's their plant to make lidocaine and they don't always they're not always able to pivot very quickly because what these pharmaceutical companies do is they will allocate a certain line you can eat kind of all kind of kind of picture and
00:19:12
Speaker
a manufacturing plant, you have, you know, lines of production in a car factory, you've got, you know, several lines making different pieces of the car.
Strategies to Manage Drug Shortages
00:19:21
Speaker
So they've dedicated, let's say one or two lines to making lidocaine. And then the rest of the lines are making, you know, bupivocaine, ripivocaine, etc. They are not always able to pivot quickly and say, okay, we can shut down the bupivocaine line for three weeks.
00:19:40
Speaker
and make lidocaine because of the shortage. A lot of times they just keep on going and they go based on the quota of what they've produced in the last year in the usage numbers for that year. So that leads us to another reason why shortages happen.
00:20:00
Speaker
let's say two companies in the world make this drug, and one of those companies gets shut down for whatever reason, or the company decides not to make that drug ever again. Like they can internally determine, is this something we want to continue making? A lot of times it's a cost versus revenue type scenario.
00:20:28
Speaker
and for our generic drugs that many of those we use in our surgery centers. So your, your, your anesthetics are all generic. Many of your antibiotics that we use in surgery centers are generic. You are also using items for nausea that are generic. So many of these items are not what we call brand name or first to the market items. And so those particular products are the first
00:20:58
Speaker
where a manufacturer might decide to discontinue it. And so if your two companies making it and one company goes down, that other company is now kind of trying to address the whole United States production, or even worldwide production of that drug. And again,
00:21:20
Speaker
they may not necessarily be able to pivot that quickly. And so that leads to a drug shortage. They, you know, they may get, you know, a month's notice or a little bit of a notice to say, Hey, this other company has decided they're no longer going to make this, but that doesn't give them enough time to ramp up that production. Yep. Yep.
00:21:44
Speaker
Those are the predominant reasons for drug shortages. Another one is, you know, kind of self-explanatory, but your natural disasters. So there was Hurricane Irma, the one that hit Puerto Rico several years ago, and that was in 2000.
00:22:06
Speaker
no, it had to have been 2014, 2015. There was a hurricane that hit Puerto Rico. And there was one manufacturer in particular that made much of the IV fluids for the United States and their plants were there on that island. And so that totally destroyed their plants. And that particular company was left reeling to now figure out where they were going to produce
00:22:31
Speaker
IV fluids at a different plant that doesn't typically make it for that company. But that caused a worldwide shortage on your IV fluids at that time.
00:22:44
Speaker
That makes sense. And the kind of direct relationship there between kind of the supply and demand factors in terms of a lot of those shortages being caused by just a simple lack in supply for a variety of reasons, it seems like those are things that can directly impact the center when those things occur. And I guess I just would follow that on, in the event of a shortage, do you have any kind of guiding tips for surgery centers to kind of be able to leverage to kind of navigate those situations?
00:23:14
Speaker
Right. So that's a great question. And I think that folks maybe don't plan ahead for that. So again, having a consultant pharmacist on board that can help you with navigating drug shortages. But if there isn't a consultant pharmacist on board, keeping an eye out on your pharmacy organization
00:23:39
Speaker
drug shortages pages because they will post expected drug shortages. Now, it goes back to that dedicated staff member that I mentioned earlier. Many times ASCs may not have a dedicated staff member and they certainly don't have a dedicated staff member to be monitoring drug shortages and addressing those. But if they did and somebody was able to kind of anticipate
00:24:09
Speaker
direct shortages coming up and either you know a order additional supply or b order additional supply of a easy alternative and i say easy because there there's always a plan b and a plan c but the plan a is usually the easiest right you can just order up on supply
00:24:31
Speaker
looking at your usage for 30 days in ordering, you know, let's say, you know that there's going to be a drug shortage for two months ordering a two month supply. And that would be again, the easiest, you've got additional supply, maybe you spent a little bit more on your drug budget, budget, but you're going to prevent any time spent on that drug shortage in the future. Your plan, yeah, your plan B and C would be
00:25:01
Speaker
determining what is an easy alternative. And so that would be something you would communicate with your pharmacist, but if not your providers, your surgeons, your anesthesia team to see what would be a plan B that we could use as alternative and order that instead. Sometimes plan B can be just ordering different sizes or different preparations of that drug, right? Maybe you're used to always ordering a 30 ml vial,
00:25:30
Speaker
And you know what that looks like. You know it has a green cap and it looks like this, but you may have to order a smaller vial or a larger vial during that drug shortage.
00:25:41
Speaker
And then as I mentioned, using alternatives that are in the same drug class, you can get those particular drugs and use those. So a good timely option right now that everyone is dealing with is your local anesthetics, your lidocaine and your bupivacaine can be very difficult to find. So maybe you transition to ropivacaine and you make sure with your anesthesia team,
00:26:10
Speaker
all we can get right now is for a pivot cane. Are you all you know, okay to use this everyone is familiar with for a pivot cane and the dosing and then you roll that out during this short shortage. So that'd be a plan B a plan C would be where you would have to make a drastic change. Let's say you typically give a certain medication pre-op
00:26:37
Speaker
Well, now you're saying to yourself on every case, which patient type really needs this pre-op. And if they really need it, we have it available to them, but the rest of the patients maybe don't get this medication pre-op. So that would be kind of your plan C.
00:26:54
Speaker
That makes a ton of sense. And I think that gives our listeners some really good options on kind of how to approach that and how to be prepared for those scenarios.
Preventing Diversion of Controlled Substances
00:27:02
Speaker
So, you know, I want to pivot us a little bit on this because I know there's some areas that your consultancy really specializes in. And I want to give us some time to be able to talk through that. And one of those topics is around controlled substance diversion prevention. And that's an area that I want to make sure our listeners get a chance to kind of understand and also understand
00:27:22
Speaker
some of the approaches that you recommend around that. So for any of our listeners who aren't necessarily familiar with what that is, can you kind of explain that a bit and also maybe talk a little bit about kind of some of the processes and steps that you tend to recommend?
00:27:37
Speaker
Sure, of course. So controlled substances, you know, most people are familiar, but these are the medications that have restricted ordering based on their DEA schedule, and as well as we need to clearly document that inventory usage, wastage, and destruction. So the DEA classifies those between a schedule one through five.
00:28:04
Speaker
In our surgery centers, we're using schedule two, which can be, you know, one of the highest controlled substance levels that has medical use. So you're scheduled to medications, for example, or your fentanyl, your morphine, your hydromorphone. And those have to be ordered very specifically with a DEA form or through an electronic ordering system.
00:28:31
Speaker
which we refer to as CSOS. And then your schedule three through fives are still of medical use. They have some addictive potential, but they are not as structured in their ordering process as those scheduled to medication.
00:28:49
Speaker
Yeah, so my recommendations would be to have a structured process in place going back to the organization of your med room. Many of your state boards of pharmacy have very particular rules on where controlled substances can be stored as well as the DEA.
00:29:13
Speaker
they want a very limited access to where those are stored. So simple explanation would be having a locked med room and that med room has a numerical code that's used or maybe a badge code that's used and that's very limited to who can get in that med room.
00:29:36
Speaker
And then you have a locked cabinet, again, where those controlled substances are stored, and whether that's a key code or a badge code, again, with limited access.
00:29:48
Speaker
And then having a very structured way of one person ordering, a different person receiving those medications, and then a pharmacist or another person coming back and verifying. This is what was ordered, this is what was received, and this is what our perpetual inventory is.
00:30:09
Speaker
That will identify simple things such as just counts were incorrect, but potentially any diversion that's happening. If you have the same person doing every step, there's definitely an opportunity where diversion could occur, right? If that person had a situation where they were addicted or they were selling those medications,
00:30:37
Speaker
they could order, they could receive, they could modify the inventory if there are not multiple people involved in that process. So that would be kind of the easiest recommendation is to define what that process is, define who is going to do each set of those processes, and that somebody's coming back and just verifying yes, this is what we ordered, this is what we received, and this is what was put onto the inventory.
00:31:07
Speaker
Some other processes to have in place would be to really limit the areas that you have your controlled substances stored in and go throughout your surgery center. What I will see if I walk into a surgery center that I'm adopting from someone else
00:31:24
Speaker
is that you'll have medications stored in multiple areas of the center and some of them are not secured, some of them are not maintained. So trying to limit the areas where those medications are stored and especially those controlled substances.
00:31:43
Speaker
For surgery centers, many of those do not have automation. So in our hospital systems, we have automation where we store those medications in what we call dispensing cabinets. And there's a process for pharmacy to load them, nursing to pull them, and it's all recorded electronically.
00:32:05
Speaker
But in surgery centers, typically that's all done manually. So you do want to have a process in place where medications are put into what we call anesthesia kits. Those kits are standardized. We know what we're going to put in a teach kit. The kit is numbered. The kit is sealed. We know if
00:32:29
Speaker
we give that kit to an anesthesia personnel for the day, that it's also returned that day. So having a process in place that you know who's going to fill the kit, who checks the kit, and who is making sure that all the kits get back into that med room at the end of the day and someone maybe didn't walk out of the center with it, or that any of the medications are missing from the kits.
00:32:56
Speaker
So those are pretty easy. I mean, they sound pretty easy, but I do see that those processes are not in place in some surgery centers.
00:33:06
Speaker
Yeah, those are all really good insights. And it seems like there's a lot of easy and straightforward steps, but I can see how when it comes to change management and making new processes on any team, a surgery center or otherwise, it can be tough for people to adopt some of those changes. But considering the risk factors there, it seems like taking those steps would be a slam dunk for any surgery center.
00:33:27
Speaker
That that's super helpful.
Role of Consultant Pharmacists in ASCs
00:33:29
Speaker
I know we're kind of pushing up against our normal kind of time here, but there is something that we do every single episode with every single one of our guests. And we always ask our guests, what is one thing our listeners at their surgery centers can do this week to improve their surgery center? Yeah, I think that's a great topic to have, you know, for every speaker that's coming on. So I love that.
00:33:54
Speaker
One thing from a medication management perspective is having a consultant pharmacist. Whether you have a consultant pharmacist, at the very minimum, having a dedicated staff member that can help you with your medication management. That will lead to standard of care, best practice, preventing drug errors, having a safe, effective way to give medications in your surgery center,
00:34:21
Speaker
And allocating the staff to that. So if the consultant is coming in and helping with those processes or the dedicated staff member is given time to work on those. I think that's the simplest answer to walk away with. And for people, whether that is the owners of the surgery centers or the providers, knowing how important and how time consuming the medication process can be.
00:34:50
Speaker
That's super helpful. And I feel like this episode's got a ton of really good nuggets in it. We try and make some great clips coming out of every episode so we can share some of them in addition to the whole episode. And it's going to be tough for us to choose which parts to use as clips. But, Amy, it has been fantastic having you on. I know our listeners are going to really enjoy this one. Thank you so much for your time and for your insights. Thank you so much for having me. And I wish every ASC the best. Awesome.
00:35:22
Speaker
As always, it has been a busy week in healthcare, so let's jump right in.
Impact of Price Transparency Laws on ASCs
00:35:27
Speaker
In our first story today, Virginia ASCs are to be included in the implementation of the state's hospital price transparency laws. This story comes from ASCA's government affairs update, so major shout out to Stephen Abresh of ASCA for summarizing this so clearly for us.
00:35:44
Speaker
On April 11th, Virginia Governor Glenn Youngkin signed into law House Bill 481. The measure requires hospitals to make publicly available on their websites a machine readable file containing a list of all standard charges for all items and services provided by the hospital. Now, a lot of that language really isn't new. But on September 7th, a committee got together to discuss recommendations for implementing the law.
00:36:13
Speaker
Now, it's important to note that in Virginia, ASCs are actually referred to as outpatient surgical hospitals. So if you look through the minutes, just a heads up that that's what you'll be looking for, not ambulatory surgery centers. By the end of the meeting, though, the committee unanimously recommended that ASCs should be subject to the state's hospital price transparency requirements as well.
00:36:35
Speaker
And according to the House bill, the deadline to comply is July 1st, 2023, which we all know will come up sooner rather than later. So first, for all the ASCs in Virginia, please make sure you check out the episode notes for all of the links so you can learn more and start preparing for this. And then for the rest of the states, it's important that we take what's happening in Virginia as just another wake up call that more and more transparency requirements are coming your way.
Physician Pay Cuts and ASC Efficiency
00:37:04
Speaker
According to an article written by Becker's ASC, declining pay is pushing more and more physicians to ASCs. CMS proposed a physician FICA of 4.42% in 2023. And if that takes effect, it will continue to sweeten the deal for physicians who may currently be on the fence about whether they should transition their cases to a surgery center or not.
00:37:29
Speaker
We already understand the value of working in an ASC over a hospital. Higher efficiency, safety, better outcomes, better work-life balance, but declining pay in a hospital setting will impact physicians' pockets, and we all know that there is no bigger driver than that for most of them. So don't hesitate to start networking and doing some marketing to your local physicians and letting them know the benefits of performing cases at your surgery center, especially
00:37:59
Speaker
if that physician fee cut does take place.
Revenue Cycle Solutions for ASCs
00:38:03
Speaker
Our third story comes from PR Newswire. Last week, National Medical Billing Services announced that they have officially acquired MedTech. MedTech was founded in 2001 and offers medical transcription, coding, billing, and other software products to ASEs. And National Medical is one of the industry's leading providers of revenue cycle management solutions, so you can imagine the synergy here.
00:38:27
Speaker
Both companies have a goal of being able to, one, provide ASCs with a complete end-to-end revenue cycle solution, and two, help ASCs get paid more and, of course, get paid faster. So by acquiring MedTech, National Medical will be able to move more quickly on both fronts and expand their product offerings. We'll be keeping a close eye on how this develops and what it means for the industry, but for now, congrats to both companies and excited to see where you go from here.
00:38:56
Speaker
And to end our news segment on a positive note, while the story isn't directly related to ASCs, it's a win for help for lowering health care costs, which I think everybody can get behind.
Biden's Order on Over-the-Counter Hearing Aids
00:39:08
Speaker
President Biden issued an executive order requiring the FDA to allow hearing aids to be sold over the counter to anyone 18 or older in the next four months. Now, this was something that was actually signed into law four years ago, but no action has been taken.
00:39:25
Speaker
so president biden issued that executive order to kind of get things moving and consumers with mild to moderate hearing impairments can actually purchase these hearing aids without the need for medical exam prescription or fitting and the fda estimates that.
00:39:42
Speaker
This could lower average costs by as much as $3,000 per pair. And you can get them at Walgreens, CVS, Walmart, Sam's Club, and Best Buy. And from what I can tell, the costs range from $199 to $999. And while conversations happen all the time around lowering costs, it's really great to see something actually happening. And for those of you who have hearing impairments or know someone who does, I'm excited that you now have this option available to you.
00:40:13
Speaker
And that news story officially wraps up this week's podcast. Thank you as always for spending a few minutes of your week with us. Make sure to subscribe or leave a review on whichever platform you're listening from. I hope you have a great day and we'll see you again next week.