A Q&A with Kathy Bryant

today’s surgicenter checked in with Kathy Bryant, president of FASA, for her take on hot topics such as the recently announced merger between FASA and the American Association of Ambulatory Surgery Centers (AAASC), as well as the much talked-about payment system final rule from CMS.

Q: How will the merger between FASA and AAASC — and the creation of the new organization, the Ambulatory Surgery Center Association (ASC Association) — help create a unified voice for the industry?

A: History shows us that when an industry has one association speaking for it, it can convey a louder and stronger message than when multiple associations are involved. FASA and AAASC have always worked hard to promote the same message on Capitol Hill, and I think that we have succeeded for the most part. However, that being said, there were two legislative seminars, two alerts going out to members, and small differences in these outreach efforts may have confused people a little bit. I think where it has been hardest is on our respective members. They get a letter that, from FASA’s standpoint, may say exactly the same thing as AAASC but worded differently, and then they get a letter from AAASC … we might agree that the letter has the same message but we were not aware until recently how confusing it might have been for people. By having one master plan of how we do everything, we expect to be even more effective.

Q: How will this unified voice be received by lawmakers?

A: The same lawmakers, when approached by representatives of two separate associations, may have been slightly confused, but not because they were hearing different messages. It’s just that they would say to whoever came in last, “Didn’t I meet with someone from your group last week?” With one organization, such visits will be coordinated and thus there will be no confusion.

Q: What do you look forward to most when the merger is complete?

A: What I am most excited about is having an integrated board focusing all of their attention on what we as an organization can do for the members and for the industry as a whole. I think that the new organization will bring together the best of both organizations and will offer enhanced services to our membership. It’s been exciting for me, over the last few months, to learn more about AAASC and the services they offer. Not long ago I had the opportunity to visit AAASC headquarters in Johnson City, Tenn., to meet their staff individually, review their programs and learn more about what they were doing for the industry. Even though I generally knew about some of these initiatives and projects, I learned a great deal through that process. I think that our board meetings will be exciting in that same way — the discovery process.

One thing I am focused on is the unification process at the annual meeting, which will be held May 14-17, 2008 in San Antonio. And we’re very excited about having Magic Johnson as the headlining speaker to discuss change. Originally, he was invited to speak about change because of the changes affecting ASCs; now that message will have a double meaning as ASCs will have a new association. The meeting will be our first opportunity to come together as the new association.

Q: How will the state ASC associations continue to operate as the merger takes place?

A: One of the things I have heard from the state associations repeatedly over the last few years is that they don’t want to have to make choices between national associations, and this merger means they won’t have to. Certainly, initially I expect us to continue to provide all of the services offered by both groups. For example, FASA manages five state ASC associations; I believe the new group will manage those five associations. AAASC managed the Web sites for a number of different state ASC associations, and I imagine that the new group will continue to offer that service. Over time, will we put some of those things together in a different package? Maybe. We will definitely continue to provide to the associations various legislative alerts and assistance with these issues as needed.

Q: Speaking of state associations, what are the important issues states will face in the coming year?

A: I think there are a number of issues. At the state level, as at the federal level, I think our biggest challenge is educating legislators about ASCs and the benefits they provide, and the more that legislators know about ASCs, the better for us, of course. For example, the time we spent this year at the National Conference of State Legislators meeting was very important. I suspect that in states in which we haven’t done as well at educating lawmakers as we could have, problems might surface in 2008.

I think the issues we see next year will be the same kinds of issues states have faced in years past. I think ASCs continue to be concerned about insurance issues and I think we will be the aggressor in trying to get legislation more favorable with regard to these insurance issues. I also expect we’ll see some attempts at stricter or expanded CON laws, or some physician ownership restrictions. We will see state-bystate issues that are unique to the area.”

Q: What reaction to the new payment system are you still seeing in the industry?

A: I think a lot of people like to focus on things when they are final, and the final rule from CMS isn’t entirely final yet. I am amazed at the number of people who have heard me speak at various meetings throughout the year and they still come to listen. I do address these issues frequently, and I would think it would be too much to hear me over and over, but people say they learn more each time. In general, ASCs are so wonderful, and they are used to dealing with changes. They are trying to find out as much information as they can and then figure out how to reconcile with the changes. Reaction really does depend on whether you are a facility that does a lot of procedures that are going up in reimbursement or those whose payment is going down. I think some ASC operators are looking to diversify a little more to ameliorate the cuts. They are trying to figure out how they will work under the new system and a lot of that depends on how the private payors respond.

ASCs will need to review their contracts, examining them to see what they really require. If you have something in your contract you don’t want to live with under the new system, then you’ll want to be flexible to whatever the insurer is saying. I think that right now, people are getting all the information they possibly can, making sure they understand it and going from there.

Q: Any advice for ASC operators on how to weather the coming storm in 2008?

A: I think they need to be completely involved in what’s happening in the industry, including responding to surveys and legislative alerts, contributing to political action committees, and communicating with their representatives on Capitol Hill. We are a small industry and with all of the attention on us right now, we have to make sure we are maximizing our effectiveness. Although we will soon be an even stronger national association, I am a much better lobbyist with an active membership behind me than I am just based upon my individual skills. 

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