Management consultants like to advise their clients to perform a SWOT analysis on a regular basis, because it is an effective tool for strategic planning. In the current environment, it is especially important to honestly identify internal strengths and weaknesses and external opportunities and threats. Successful practices use this tool to constan...

You just know it when it happens. It is that sudden shift in events that eerily presages a change in one's fortunes—and not necessarily for the better. For decades now, anesthesia practices have been able to rely on certain unchanging rules when it comes to the reimbursement of the providers' services. This includes those groups that utilize certif...

It goes without saying that hospitals could not run their operating room suites without anesthesia. It has been said that the two most significant advances in medicine have been antibiotics and anesthesia. While surgeons appreciate and their patients benefit from the services anesthesia providers perform, few realize just what a powerful database i...

Along the edges of America's more mountainous regions are roads that motorcyclists call "the twisties"—named for the large number of hard turns that come at you in rapid succession. These types of winding roads are highly valued by riders as they afford the thrill of leaning into the curves at respectable speed. But it is not only the biker communi...

Anesthesia profitability has been defined in many ways over the years, but rarely has it been defined in a way that actually relates to the fundamental economics of the specialty. Physician anesthesiologists used to define it in terms of their own compensation. A profitable practice was one where the physicians earned a good income. This assumed th...

It was akin to what they call in Louisiana lagniappe (pronounced "lan-yap"), meaning a little something extra. Except in this case, it was excessively more than expected. Back in 2019, the U.S. Internal Revenue Service (IRS) seized a Lexus and $919,250 in cash from a Florida man who was mistakenly sent a tax refund of $980,000 on a reported income ...

Vendors of automated anesthesia record systems would have you believe they are practically god's gift to the specialty of anesthesia. They will capture more information about each anesthetic more conveniently and report it back more legibly than paper records ever could. They will also enhance the completeness and accuracy of billing by ensuring th...

"Plan the work, and work the plan," as the old saying goes. Where would any of us be without taking the time to plot a strategy for success as it pertains to education, career, relationships or even the annual summer excursion. Everything worth attaining requires at least some measure of forethought. The Office of Inspector General (OIG) of the U.S...

Many of our clients have not made a significant commitment to the management of chronic pain, but it is a constant topic of conversation during strategic planning sessions. For many anesthesiologists, chronic pain is perceived as a logical line of care extension. Afterall, the specialty of anesthesia focuses on spinal and nerve anatomy and the use ...

What a spread. Holiday dishes taking up three counters were a wonder to behold. Gazing inevitably led to grazing—a little of this and some of that. It didn't take long before the plate was full. From Thanksgiving to New Years, most Americans were treated to a tasty assortment of satisfying cuisine and rich desserts. As we look to the beginning of a...

As we close out 2022, most of our clients are wondering what their revenue will be for calendar 2023. It is a very good and useful question. The fact is that there are three distinct variables in the revenue equation, and each has been impacted by a variety of internal and external factors. The three factors are the volume of cases, the acuity of c...

Repetition and addition—that's the formula for effective learning, especially when it comes to mastering a second language. You go over what you previously practiced and then add new vocabulary words or additional grammar nuances as you progress each day. At some point, you may even be provided various charts showing verb conjugation and noun decle...

Summary: The Medicare-based quality reporting programs can be daunting to navigate for the healthcare provider. This alert provides an overview of the MIPS program for 2023, including reporting requirements, measure updates and recommendations for anesthesia groups relative to overall participation.The Merit-based Incentive Payment Systems (MIPS) p...

SummaryThe 2023 Medicare fee schedule contains new rules that will impact many of our readers. This alert will discuss changes that will primarily affect those in a chronic pain practice but that may also impact some anesthesia and critical care providers."I feel a change comin' on"; it's a lyric that Bob Dylan used to express the societal transiti...

Summary: Among the many documentation components required on the anesthesia record is the provider's signature. However, many don't realize that there are several attendant rules surrounding this basic task that make this component a bit more complicated than one might initially think.The delivery man comes to the door with an expensive package. Yo...

The finalized version of the Medicare Physician Fee Schedule for 2023 has been published. While it does not contain a large number of changes for the anesthesia community, there are a few changes that may significantly impact our readers in the new year. Three of these are detailed in today's alert.The yearly ritual begins. No, it's not the one tha...

Summary: While general surveys of anesthesia practice compensation may have some value, it is more important to assess what would cause a provider to want to join your group or to leave your group. Those potential causes are analyzed in today's alert.One of the most perplexing challenges in the current anesthesia market is determining what is a fai...

You're doing fine. At least in terms of your own personal bubble, things seem to be okay. But there are forces from without that may soon push and poke at that bubble. Consider the chaos that is certain to ensue when the bubble finally bursts.Summary: While anesthesia groups may be chugging along just fine, there are stressors being felt in the hea...

Summary: Collecting patient copays and deductibles, where applicable, is no slam dunk for billing services or collection agencies. Americans are increasingly reticent, and even recalcitrant, when it comes to their willingness to pay whopping medical bills. Today's article explains the current issues with collecting from patients and explores the q...

Summary: The rules surrounding the use of ABNs for Medicare beneficiaries are robust and readily available. When non-Medicare patients present with non-covered services, however, the provider will find that the notification rules are anything but uniform. Care will have to be exercised to follow the diverse provisions of each payer's expectations.T...