In its March report to Congress, the Medicare Payment Advisory Commission calls for a 0.6 percent rate increase for ambulatory surgical center services in 2010 to better reflect the changes that have occurred in the field over the past several years.

The commission also wants ASCs to start submitting cost and quality data to the Department of Health and Human Services "as soon as feasible."

MedPAC's analysis of ASC services and industry trends shows continued growth in the number of ASCs and the number of Medicare beneficiaries they serve, as well as a $1 billion increase in Medicare revenue for ASCs between 2002 and 2007. The commission concludes that a 0.6 percent increase in payments for their services would "balance several goals," including "maintaining beneficiaries' access to ASC services and providers' willingness and ability to furnish those services."

MedPAC adds that requiring ASCs to submit cost and quality data would help its analysts determine whether further adjustments to payment rates are needed and "would allow payments to be made on the basis of the quality of care."

Irene Tsikitas

An electrocautery device's contact with an alcohol-based skin prep allegedly ignited a flash fire on a patient undergoing neck surgery in a Nebraska facility on Feb. 3.

According to Paul Baltes, spokesman for the Nebraska Medical Center in Omaha, surgical staff extinguished the fire in a matter of seconds by dousing it with saline solution.

A burn surgeon treated the patient in the OR, allowing the scheduled procedure to be completed, says Mr. Baltes. The patient, who suffered minor injuries, spent the night in the hospital's burn unit and was discharged the following day.

The incident, which is under investigation by federal health authorities, emphasizes the importance of understanding and maintaining fire safety practices in the OR, especially during head and neck procedures, which the American Society of Anesthesiologists classifies as high risk in its 2008 Practice Advisory for the Prevention and Management of Operating Room Fires.

During such procedures, the ASA recommends surgical teams consider the patient's depth of sedation and oxygen dependence. When open gas delivery systems are used, the ASA recommends that providers stop the delivery of supplemental oxygen - or reduce its delivery to the minimum requirement to avoid hypoxia - and wait a few minutes before activating an ignition source around the patient's head or neck.

Daniel Cook

The infusion of warm water, rather than air insufflation, makes colonoscopy easier on patients who have foregone sedation, according to a recent study.

Ninety percent of patients who underwent unsedated colonoscopies with water distension said they would repeat the procedure without sedation, as compared to 69 percent who underwent the process with air insufflation, says a study published in the March issue of Gastrointestinal Endoscopy.

Water infusion was also found to improve cecal intubation rates. The study showed the rate for water infusion patients at 97 percent, compared to 76 percent for insufflation.

Researchers at the Veterans Affairs Sepulveda Ambulatory Care Center in Los Angeles reviewed the results and responses of 125 patients treated at the center between June 2005 and October 2007 for the non-randomized, observational study.

Kent Steinriede

Most of the 66 readers who took last week's online poll admit to having weight problems, with 48 percent describing themselves as "slightly overweight" and 21 percent as "severely overweight."

People with a body mass index of 25 or above are classified overweight, while those with BMIs of 30 or above are considered obese and at serious risk of heart disease, diabetes and some cancers. The National Center for Health Statistics reports that 32.7 percent of Americans are overweight and another 34 percent are obese.

This week's poll asks what type of anesthesia you use for your cataract cases. Go to our front page to participate in the poll and view real-time results.

Dan O'Connor