It is an oddity of human nature that we are drawn to television programs that continue to extend the story, where succeeding episodes build upon the plotlines of the last. What used to be relegated to the day-time soap operas of the sixties and seventies became commonplace in nightly dramas from Dallas to Downton Abbey. Remarkably, that soap opera ...

Summary: Anesthesia is entering a transitory period where the reliance on negotiations with insurance companies as the sole path to profitability is no longer the sure strategy it once was. New realities have set in, and new solutions must be considered. Imperiled ProfitabilityHistorically, the ability to negotiate favorable contract rates has bee...

Summary: Leadership is indispensable. As hospitals search for better ways to cut costs and improve quality, many have discovered a new model of care delivery that is being led by anesthesiologists. The trail boss in the series Rawhide was in charge of the whole shebang, but he needed a Rowdy Yates to drive them doggies home. We're talking about th...

Summary: Billing for all the services performed by anesthesia providers is a massive undertaking. A myriad of rules and requirements must be absorbed and implemented. Today's article provides examples of why the anesthesia specialty is like no other. The once renowned Harvard economist, John Kenneth Galbraith, wrote that anyone who thinks writing ...

Summary: The federal government has recently opened up the independent dispute resolution process for out-of-network providers who are unhappy with their reimbursement for services. Specific instructions are provided in this alert for beginning this process.Such crises don't often occur; but, when they do, it's good to have a workable resoluti...

Summary: Two new words are now an integral part of the anesthesia management conversation. They are scope and creep, and they have everything to do with the future or a practice. Understanding how to manage their impact is the key to ongoing viability and success. Anesthesia Market DynamicsThe vocabulary of anesthesia practice management is now fo...

SUMMARY: More and more cases are moving from the hospital to the surgery center. How involved should anesthesia groups be in the running or even owning of these facilities? Today's alert looks at the pros and cons.In 1994, country singer Neal McCoy had a number-one hit on his hands. It was a song about finding the perfect match in a lifetime mate. ...

SUMMARY: Contributing resources to the ICU is not uncommon for anesthesia groups, but there are nuances that each group should keep in mind before making a significant commitment to this line of service.While academic anesthesia departments often provide services in the Intensive Care Unit (ICU), this is quite rare among private practices. Hence th...

Summary: Medicare places a new reimbursement hurdle for providers who perform spinal neurostimulator services. However, payment is not restricted where the pain practitioner's paperwork passes muster.In the Cold War spy thriller, Firefox, Clint Eastwood's character is in the Soviet Union on a clandestine mission for the American government. He is ...

SUMMARY: Many anesthesia groups have a chronic pain component; but how beneficial is it from an overall financial standpoint? While some make it work, it is very difficult to set up and maintain a profitable pain practice.Some of our anesthesia clients are actively involved in the provision of chronic pain management services. Usually, the chronic ...

SUMMARY: The prevalence of opioid usage among America's patients has generated the need for a set of protocols to be used by those providing acute pain care. A consortium of 15 medical societies has recently provided best-practice recommendations.The second law of thermodynamics, which is an axiom of accepted science, says that, over time, things t...

SUMMARY: As of February 22, at least six lawsuits have been filed opposing certain regulations arising from the No Surprises Act. A recent ruling in one of these cases has just changed the legal landscape in favor of anesthesia providers.Not every battle is a losing one. Every now and then, you win. That seems to be the case—at least for the t...

Every year, the government's watchdog agency produces a list of healthcare services and procedures they plan to scrutinize for the purpose of determining the potential for significant abuse by the provider community. The 2022 list contains a few items that will be of interest to anesthesia and chronic pain providers.There is an age-old teaching th...

Summary: The practice of anesthesia is preeminently clinical, but few practices can sustain themselves without adhering to sound financial and contract management principles. What are the risk areas faced by today's anesthesia groups and how can they be safely navigated? Addressing these concerns is more imperative than ever.Anesthesia providers ha...

SUMMARY: Audits of anesthesia records and claims are inevitable. The question is, how well will your group members' documentation hold up under the bright light of scrutiny? A few strategies may help them to survive a payer audit.Don't think they're not out there. They are . . . just around the corner, looking over your shoulder and ready to pounce...

SUMMARY: Today we explore is big really better? Many a practice has dedicated considerable time and energy to the discussion of merger and expansion options. This question is more relevant now than ever; the specialty is more at effect of dramatic and dynamic market forces than few ever anticipated. Plotting a secure and financially viable pat...

SUMMARY: Peering into the inner workings of the heart is nothing new for poets and philosophers, but anesthesiologists have a seen a thing or two, as well. However, the standard TEE technology can only convey so much. A new TEE code allows you to bill for a much better view.​One of the more recent topics discussed and debated among theoretical phys...

SUMMARY: Despite education and efforts to reduce the abuse of opioids among Americans, the addiction crisis continues. To what extent can pain management and anesthesia practices play a part in reducing America's dependence on these substances?A new book has brought one of the nation's most serious health crises into clear focus. Empire of Pain: Th...

​Summary: Even before the No Surprises Act went into effect, major national healthcare organizations raised concerns about conflicts between the Act and its implementing regulations. Battle lines are now being drawn.As most of our readers know, federal law now protects insured patients from receiving surprisingly high medical bills from ancillary p...

Summary: The year that was involved a transition from pandemic-induced reductions in case volumes to gradual recovery. However, other market and demographic forces affected practices in 2021 and will continue to have an impact on the year ahead. By all accounts, 2021 was a challenging year for American medicine. The pandemic, which we all thought ...