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(Editor's note: This month's issue includes the second part of a two-part series on natural orifice surgery. In this month's issue, we explore patient selection, physician skills, and tools in development. Last month, we gave you an overview of the current status of the surgery.)
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The company Starbucks made a significant business decision a few months ago. Their board decided that they needed to focus on what they thought they did best: Operate as a specialty coffee store.
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(Editor's note: In the second part of a two-part series on contract negotiations, we give you tips for handling contract renewals, and we tell you how to identify the best potential contracts. In last month's issue, we told you what to do when your contact is up for renewal.)
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Identifying the best payers with whom to contract in your area can be done by researching local employers, but another way is to pay attention to what insurance cards you see from your patients.
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Outpatient surgery programs will have to look for physicians with a combination of skills before granting privileges for natural orifice surgery, says Marc Bessler, MD, director of laparoscopic surgery and director of Obesity Center, New York Presbyterian Hospital at Columbia University, New York City.
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Despite being pressured, The Joint Commission (TJC) has not dictated in the revised "Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery" that surgeons must be the ones who mark the surgical site.
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The Centers for Medicare & Medicaid Services (CMS) has proposed a 3% payment increase for hospital-based outpatient programs for calendar year (CY) 2009, while ambulatory surgery specialties will see payment changes ranging from -6% for procedures on the digestive system to 19% for procedures of the musculoskeletal system.
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In every element of the revised 2009 "Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery," including verification of procedure, marking of site, and taking time out, The Joint Commission (TJC) has "gotten a bit more specific about who does what and when," says Peter Angood, MD, vice president and chief patient safety officer for TJC.
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Let's have a show of hands of those who have real concerns about the economy and the overall health of business today. (Cue to author who is waving both hands in the air).
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A 4% annual increase for the life of the facility is not a typical offer from a payer negotiating a contract with an outpatient surgery facility, but that is exactly what was offered to, and quickly accepted by, one facility.
