EYE ON OOSS

Strong Leadership Prepares Ophthalmic ASCs for the Future

BY ADRIANNE RESEK

There has been exponential growth in outpatient surgery since the early 1980s, reflecting a commitment to providing superior services for patients in a more cost-efficient manner. The National Health Statistics Report for 2006, the last year the data was compiled, estimated that of the 34.7 million ambulatory surgical visits, 19.9 million occurred in hospitals and 14.9 million occurred in freestanding centers.¹ While the rate of visits to freestanding ASCs rose by 300%, the rate of visits to hospital-based surgery centers remained flat. Ophthalmic-focused ASCs account for a major portion of this growth, with cataract as the leading diagnosis prompting an ASC visit. But with exponential success comes exponential challenges and the need for a constantly evolving change in perspective.

An Ally in OOSS

The Outpatient Ophthalmic Surgery Society (OOSS), formed in 1981, remains the only professional society devoted exclusively to addressing the unique interests and challenges of the ophthalmic ASC community. In partnership with ASCRS/ASOA, the annual OOSS Perspective provides a forum for members and industry partners to keep up with and prepare for the challenges ahead.

Captain Chesley B. “Sully” Sullenberger speaks during the annual OOSS Perspective at ASCRS in San Diego.

“Ophthalmic ASCs are more important than ever in terms of practice success and survival, and we’re noticing a great deal of momentum in our collaboration with ASC owners and industry partners that is allowing us to leverage our voice and shape our future,” says current OOSS President Y. Ralph Chu, MD.

Combating Reduced Reimbursement Rates

As a profound example of challenges that came come with growth and success, reimbursement rates for some ophthalmic services have dropped through time, such as cataract surgery from around $3,000 in the 1980s to approximately $500 today. While medical innovations, practice efficiencies and increasing market demand have enabled the ophthalmic community to adapt, the opportunity for surgeons to utilize and participate in the ownership of highly efficient and patient-centric ambulatory surgery centers has been a key to ensuring the continued delivery of quality surgical care at an affordable cost to patients.

In addition to promoting best practices and allowing surgeons a means to communicate and share information, OOSS remains at the forefront of legal and regulatory advocacy on behalf of the ophthalmic ASC.

“At this time of changing healthcare policies, our voice in Washington, DC is really our biggest asset,” says Dr. Chu. “Being a watchdog and resource for regulations and rule changes is an essential job.”

Seeking more equitable reimbursement levels has been a priority of OOSS’s agenda since its inception.

“Hospitals are big business, and losing ambulatory procedures to ASCs isn’t something they take lightly,” says OOSS Chairman of Member Relations, Frank Cotter, MD. “The gap between hospital and ASC reimbursement rates has historically widened, and OOSS, working closely with American Society of Cataract and Refractive Surgery (ASCRS), AAO and ASCA, is actively involved in getting Congress to recognize the disservice to patients and the public and to apply inflation adjustments more evenly.”

Monitoring New Policies

OOSS also works closely with association partners on a number of other issues. Recently, the Center for Medicare & Medicaid Services (CMS) recommended a change in sterilization policies that could have posed significant and costly challenges for many ophthalmic ASCs.

“Some smaller ASCs could have been crippled with the new equipment required, even though there was no history of issues with the existing sterilization process,” says Dr. Chu. “Working in close collaboration with the ASCRS, other associations and CMS, we were successful in securing clarifications consistent with processes used by most of our members.”

Growth Through Collaboration

Similarly, and in partnership with these same partners, OOSS continues to play a significant role in enabling the expansion of ophthalmic ASC services, the development of quality measures and the shaping of industry standards to guide and improve performance.

OOSS members recently gathered during the annual OOSS Perspective at ASCRS in San Diego to mark their progress and discuss the future. The program opened with an overview of the State of OOSS by President Chu, followed by a program update by Executive Director Kent Jackson, Ph.D., and presentation of Jerome H. Levy leadership awards to Claudia McDougal, former Executive Director, and Bill Fishkind, MD, President Emeritus. Legislative Counsel for OOSS, Michael Romansky, JD, addressed the top payment and regulatory issues facing ophthalmic ASCs and related collaborative efforts.

The keynote speaker for the meeting was Captain Chesley B. “Sully” Sullenberger, named one of TIME magazine’s World’s 100 Most Influential People. The focused, unflappable and deliberate leader offered inspiration and exceptional advice to the group, encouraging members to continually build an informed foundation of knowledge and skill to minimize gaps and be ready for the unexpected. In his remarks to the membership and in a private pre-session with members of the OOSS board and President’s Council, he shared ideas common to the airline and ASC industries — emphasizing the critical importance of high standards, leadership and teamwork.

“My co-pilot and I didn’t have time that day to decide what we had to do,” Sullenberger said. “We had years of learning, defining vocabulary, and practicing best practices. That firm foundation gave us the resolve to add the final spokes in the 208 seconds we had to land the plane.”

Captain Sullenberger further stressed that theirs was a very rare event and that even training specific to engine failure during takeoff over water would not have been enough. Rather, an ongoing emphasis on the basics of flying skills and a highly collaborative team, from cockpit to cabin, enabled their survival that day.

“Globally, there’s too much dependence on technology,” Sullenberger said. “There are great benefits to autopilot, but you cannot remove the pilot, and the pilot should not use technology more than necessary. We must maintain manual skills and always be engaged mentally, even when we are using technology.”

As technology advances exponentially, Sullenberger noted during his address, demands on the persons in control advance as well.

Captain Sullenberger’s speech was an overwhelming success, holding the audience spellbound and prompting the Forum Panel of industry leaders that followed to relate his ideas to the ASC setting. Current Vice President/President Elect of OOSS, Jeffrey Whitman, MD, said, “OOSS members have access to a vast amount of information and expertise, in addition to advocacy in Washington, DC. OOSS prepares us to face whatever challenges lie ahead.” ■

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