Most anesthesiology practices provide services in ambulatory surgical centers (ASCs), and quite a few anesthesiologists have investment interests in ASCs.  With more than 5,400 Medicare-certified ASCs in the United States, 1.8 percent more than in 2012, a look at the characteristics of successful facilities and at the challenges they face should be worthwhile. Meeting the marketplace challenges is the foundation of success.  Topping the list of challenges for ASCs today, now that the implementation of the Affordable Care Act is underway, are the following: Attracting and retaining surgeons and other physicians who will contribute to the facility’s bottom line.  Securing coverage, high quality and a referral base have always been key, but as more and more physicians opt for hospital employment, the pool of unaffiliated physicians is shrinking.  More than half of new physicians are taking jobs with hospitals rather than entering private practice.  Twenty-nine percent of physicians were working directly...

ABC is receiving some very good questions from anesthesia and pain practices regarding more details on how the sequestration 2% Medicare payment cut will impact their reimbursement.  We are continuing to monitor various Medicare carriers’ websites, including Palmetto, CGS, Novitas, First Coast Service Options and NHIC. These Q&As can help you track and ensure proper payments.Question:Does the 2% payment reduction under sequestration apply to the payment rates reflected in Medicare fee-for-service fee schedules or does it only apply to the final payment amounts?Answer:Payment adjustments required under sequestration are applied to all claims after determining the Medicare payment including application of the current fee schedule, coinsurance, any applicable deductible, and any applicable Medicare Secondary Payment adjustments. All fee schedules, Pricers, etc., are unchanged by sequestration; it’s only the final payment amount that is reduced. Question:How is the 2% payment reduction under sequestration identified on the electronic remittance advice (ERA) and the standard paper...