SummaryUnited Healthcare has announced a new policy intended to direct a long list of procedures to qualified surgical centers. This may be a positive development for anesthesia practices, even though it may reduce hospital volume.The cost of healthcare is slowly overshadowing other considerations in American medicine. Physicians tend to focus thei...

SummaryMost anesthesia practices accept the need to provide key surgeons two 'flip' rooms so they can be more efficient and productive; but how does this requirement impact the anesthesia practice? Most do not really know but it is an important question.Traditionally, anesthesia staffing has involved the assignment of a provider—either a physician ...

SummaryOpportunities for billing ultrasound were expanded for anesthesia providers in 2019—specifically in connection with invasive line placement. This article seeks to provide helpful guidance on payment issues and documentation requirements.We recently provided you information relative to ultrasonic guidance (USG) in connection with post-operati...

The QPP Final Rule for 2020 showcases some changes that are important to understand for all anesthesia and chronic pain providers. The penalties are increased, the risk is greater if you want to report, and a shift in strategy for reporting altogether are included in this review. On November 1, 2019, CMS released the 2020 Quality Payment Program (Q...

Important changes are in store for anesthesia providers in 2020 and 2021. A preview of the MPFS Final Rule is out and it reveals some surprising provisions. This article is meant to provide an initial take on the most relevant items pertaining to our clients.Do you ever get the feeling that things are going along a little too well? At least as it c...

SummaryAnesthesia groups are increasingly providing services outside of standard anesthetizing locations. They need to do more to properly track these services so that they can have a more accurate assessment of their manpower needs and overall financial standing.In the evaluation of coverage and staffing requirements, the primary focus is always t...

SummaryAnesthesia group presidents and department chairmen are under increasing cultural and contractual pressure to take on more responsibility for the perioperative space, without always being commensurately compensated.Virtually every anesthesia service agreement with a facility includes a section entitled, "Medical Director." This is nothing ne...

Ultrasound in support of post-operative pain blocks is still billable, but are providers doing all that is required? Today's alert provides a reminder of what they must document in order to be paid.If you had mentioned the word "ultrasound" to teenagers back in the 1960s, I suspect they would have thought you were referring to the psychedelic groov...

Conventional wisdom holds that the better-paying cases are migrating from the traditional inpatient setting to outpatient venues. This explains why today's larger practices are so focused on growing their surgicenter business. They view it as a matter of financial survival. Many surgeons will bring their older, sicker Medicare patients to the hospi...

On a recent trip through the Ozarks, attempting to reach a trout-filled river, our caravan of two vehicles was being guided by a GPS device that began to dole out dubious directions. All of a sudden, we found ourselves on a rut-filled gravel road that promised to go on for miles. The lead car kept going, though now at a snail's pace. The driver of ...

SummaryThe management of acute post-operative pain has become an exciting new frontier for anesthesia. New techniques and the use of ultrasonic guidance make it ever more feasible for anesthesia to implement pain management strategies that minimize the need for opioids. The question is, are you taking maximum advantage of this opportunity in your p...

Anesthesia providers are facing the real possibility of a reduction in reimbursement for acute pain services in the coming year. However, the end of the story has yet to be written.As a follow-up to our recent articles on the proposed Medicare Physician Fee Schedule (MPFS) for 2020 and our trend analysis of acute pain services, we would like to pro...

Summary The relationship between an anesthesia practice and the hospital administration can become challenging, especially when the negotiation of a hospital contract involves the determination of financial support. While it is true that sometimes the parties cannot come to terms and the administration must employ the providers, this is the e...

Summary To maintain momentum, anesthesia groups must place a priority on preparing the next generation for leadership. How can that best be accomplished? Today's article provides some helpful suggestions. So many of the client groups we serve are fortunate to have strong and able leaders. We see evidence of this as we meet with our clients, listen...

Incorporation of acute pain modalities within anesthesia practices has greatly expanded over the years, and this has brought positive changes in patient care and physician payment. However, where new techniques become "standard of care," adjustments in payment often follow.As the preeminent provider of outsourced anesthesia billing and management s...

Summary The evolution of the speciality of anesthesia from individual private practices to group entities has resulted in a variety of interesting business models, including some of the most sophisticated corporate entities that now employ thousands of providers. Is aggregation the inexorable trend of the future? Maybe not. We are starting to see ...

Summary The recently released Proposed Medicare Physician Fee Schedule for 2020 contains several revisions to the E/M and QPP (MIPS) requirements, but little will change for the average anesthesia practice—except in the area of acute pain.In the final days of July, the Centers for Medicare and Medicaid Services (CMS) released a preview of its prop...

Summary Anesthesia provider productivity is primarily determined by the level of activity and types of cases performed at a given facility. Complicated provider compensation schemes do motivate some providers to work especially hard, but in general they allow the majority of providers to work less hard than their colleagues who split the pie equall...

SummaryAmerica is facing an epidemic of drugs and addiction. The anesthesia specialty is uniquely positioned to address and reverse this national crisis. This article outlines strategies providers can pursue to mitigate opioid addiction.A couple of days ago, I came across a news item that left me in a state of stunned disbelief. The most recent fin...

Summary This article is intended to inform the reader on the relevance of reporting ASA Physical Status modifiers, in relation to billing. In medicine, innovations are often developed for one purpose, but later become relevant to other applications. The same is true for ASA physical status. This clinical tool for classifying a patient's preoperati...