Wyoming's ASC community is playing defense against hospital hysteria over a bill that would have opened the door to outpatient joint replacement surgery.

Earlier this month, state lawmakers introduced legislation that would have expanded the Wyoming Department of Health's licensing definition of "healthcare facility" to include convalescent care centers.

The bill, backed by the Wyoming ASC Association, the Wyoming Medical Society and the Wyoming Orthopaedic Society, would have let ASCs host joint replacement surgeries and other complex cases, then discharge patients to the convalescent centers for up to 72 hours of post-op care.

The committee rejected the bill on Monday, 5 to 4, but not before the representatives of Wyoming hospitals voiced their opposition to the bill in a public meeting with lawmakers. As reported in a newspaper account of the meeting, their comments characterized the bill as letting surgery centers provide the 3 days of recovery care themselves.

The hospital representatives argued that this change would threaten community hospitals' revenues, and even patient safety. "They're claiming they can do it cheaper," said Eric Boley, president of the Wyoming Hospital Association. "They would discharge the patient to a motel, then have a nurse go in and check on them. It's cheaper … because they don't have the overhead."

Not so, counters Todd Currier, CASC, CMPE, CPA, president of the Wyoming ASC Association and administrator of the Northern Wyoming Surgery Center in Cody. "We asked if we could discharge to a convalescent care center because we want this to be governed and regulated by the Department of Health," he says.

The bill's rejection ultimately "limits progress, and limits patients' choice," adds Mr. Currier. "It entitles more patients to seek healthcare outside of the state. And it limits physician recruitment."

David Bernard