Strength in Numbers: Advocating for Ophthalmic ASCs

Panelists discuss the benefits of membership in the Outpatient Ophthalmic Surgery Society.

Dr. Koch: The Outpatient Ophthalmic Surgery Society (OOSS) has been a yeoman in supporting the ASC community in numerous areas, primarily education, advocacy and leadership.

Mr. Sheffler, you manage several ASCs, and you are active in OOSS. From an administrator's point of view, why is OOSS critical to the ASC community?

Mr. Sheffler: Eye surgery is one of the highest volume operations performed in the United States, and for that reason, the government frequently scrutinizes ophthalmology for potential cost savings. Although OOSS was organized to help ophthalmologists set up surgery centers, advocacy—particularly efforts to keep reimbursement rates up—has always been a mission of the society. No other organization keeps its finger on the pulse of the Washington scene like OOSS. I believe that has been the most important function of OOSS over the years.

Dr. Koch: Dr. Patterson, you are the immediate past president of OOSS, and you have a working knowledge of its day-to-day activities. Please share your perspective.

Dr. Patterson: OOSS is the only ASC organization just for ophthalmologists. Originally, it was more of a “how-to” organization, and it still is a valuable resource for anyone building and operating a surgery center and navigating regulatory hurdles. In addition, however, the society has an important role as an advocate, and it has strengthened its position by joining with other like-minded organizations. For example, we are collaborating with the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery on a position paper we will send to the Centers for Medicare and Medicaid Services. We also recently partnered with the ASC Association, which is a powerful advocate for surgery centers in general.

OOSS Gains New Industry Supporter

Dr. Patterson: OOSS could not survive without the dues of its membership, but OOSS couldn't do what it does without industry support. Across the board, year after year, several big companies have supported OOSS via unrestricted grants, special products and services. HOYA Surgical Optics is one of OOSS's newest partners and has been generous in underwriting not only our general activities, but also special projects, such as symposia and publications.

Dr. Waltz: HOYA offers assistance through quality products as well. For example, HOYA lenses are top quality, acrylic aspheric lenses, and the special OOSS pricing has been a real boon to our surgery center's bottom line.

Dr. Tyson: In Florida, with this recession, more people are now covered by Medicaid. Unfortunately, Medicaid does not reimburse well, either on the facility side or the physician side, and many doctors aren't accepting Medicaid patients. We still do, and it's nice to have a high-quality aspheric lens that is cost-effective enough to use in these patients rather than a standard monofocal lens.

Mr. Sheffler: I want to add that HOYA has made the strategic decision to stay ahead of the curve and offer surgeons solutions to counteract the upcoming reimbursement cuts and fee reductions associated with Medicare's Sustainable Growth Rate.

For example, similar to the OOSS benchmarking initiative, The Advantage HOYA program can perform a Practice Optimization Analysis (POA) that analyzes a practice's patient demographics and provides valuable information on how your practice is perceived in your local market.

Protecting the Future of ASCs

Dr. Koch: In recent years, thanks to the efforts of OOSS, the list of procedures that can be performed in an ASC has increased. Recently, however, we have seen hospitals take aim at single-specialty hospitals and, for all practical purposes, shut down development of new physician-owned hospitals. In addition, some have suggested that ASCs should not be owned by physicians. OOSS helps us stand up to these challenges. I believe the advocacy of OOSS is critical to our survival.

Dr. Tyson: I believe OOSS will have an even bigger role in the future, because some projections show that facilities reimbursement for ASCs will stay flat, but reimbursement for cataract surgeries in hospital outpatient departments will increase. So the hospitals, which have more lobbying dollars, will want to move those cases out of our ASCs into their departments. OOSS will become much more important because we will need its political arm to advocate for us.

Dr. Patterson: Some people are predicting as soon as 5 years from now, ophthalmic and other ambulatory surgery centers will be in severe jeopardy because larger corporations, hospitals in particular, will believe it's in their best interests to take them over, either through their financial power or through regulatory action. There is much debate about it right now, and I think membership in OOSS and similar organizations will be more important than ever. Most of us don't have time to keep up with the issues and lobby on a daily basis. We need people working full-time in Washington to look out for our interests.

Not Just for Cataract Surgeons

Dr. Koch: Who should join OOSS?

Dr. Patterson: For years, OOSS was primarily a group of cataract surgeons. Thanks to the society's efforts to increase reimbursement for retina procedures, however, the surgery center environment is now a viable option for retina surgeons, and they're the fastest growing segment of our membership. We also have an anesthesiologist on our board, and he brings a different perspective to the organization. So OOSS is not just for cataract surgeons.

Mr. Sheffler: Anyone who works in an ophthalmic surgery center, from surgeons to nurses to anesthesiologists and definitely administrators, should be a member of OOSS. In addition to advocacy and information on opening and running an ASC, OOSS provides ongoing training and benchmarking information on salaries, supply expenses and throughput. It touches every area of the business of eye surgery in an outpatient setting and is an incredible resource.

Dr. Patterson: Slightly less than half of all ophthalmic surgery centers are members of OOSS, which is disappointing because many people are paying dues, doing the leg work and fighting on behalf of all ophthalmic surgery centers. While we've watched our cataract fees plummet over the last 20 years, our surgery center fees have remained stable, which right now in medicine, and for the future, is a huge accomplishment.

Dr. Waltz: We should mention that OOSS isn't just about reimbursement. The organization supported us when we had the issue with short-cycle sterilization, which was important in terms of patient safety, convenience and efficiency.

Never Too Early

Dr. Wiley: We built our surgery center about a year and a half ago, and we just recently joined OOSS. In retrospect, I wish we'd joined the society during the building process to help us with our plans and the decisions we made along the way. If we had joined earlier, I believe we would have saved tremendous time and money, and maybe we would have done things a bit differently.

Mr. Sheffler: OOSS offers discrete and timely programs and services that enable member facilities to stay current, to innovate and to establish performance standards for quality, efficiency and sustainable profitability. I would encourage everyone involved with an ophthalmic ASC to join.

OOSS Delivers ASC Benchmarking

By Kent L. Jackson, PhD, Vice President of Member Research & Development, OOSS The OOSS Benchmarking Initiative, including a comprehensive annual survey and online benchmarking tools, is the only program designed for single and multispecialty facilities for which ophthalmology is the exclusive or primary focus. OOSS Benchmarking enables facilities to compare clinical and business practices/outcomes against industry standards, with information from more than 150 facilities from across the country. Facilities utilize results to monitor performance, identify and enhance best practices, plan and set performance goals, increase efficiency and address accreditation requirements. OOSS collaborates annually with the American Academy of Ophthalmology, the ASC Quality Coalition, ASCRS, The Accreditation Association for Ambulatory Healthcare (AAAHC) and other accrediting entities to refine and improve the benchmarking process. The OOSS Benchmarking Initiative generates topical surveys based on participant interest, and provides content for educational programs presented at OOSS, AAO/AAOE, ASCRS and regional/state ASC conferences. For more information about the OOSS Benchmarking Initiative visit www.ooss.org or call (303) 910-7314.