Anesthesia Business Consultants

Weekly eAlerts Covering Regulatory Changes, Compliance Reminders &
Other Changes in the Anesthesia Industry

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Anesthesia Industry eAlerts

Sent to subscribers every Monday morning, our eAlerts deliver timely updates on regulatory, legislative and practice management developments of interest to anesthesia professionals.

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eAlerts

  • An Update on Evaluation and Management Coding for Anesthesia Providers

    December 10, 2018

    Although anesthesiologists do not bill for Evaluation and Management visits frequently, providers should be aware of the situations in which failure to use these codes can lead to lost revenue. We review these situations and other E&M coding issues of interest to anesthesia providers, including optional changes in E&M documentation requirements that will go into effect in 2019.

  • How Will Price Transparency Impact Anesthesia Practices?

    December 3, 2018

    The movement toward increased healthcare price transparency is likely here to stay.  Anesthesia groups need to be aware that patients are going to have increasing access to information about the costs of procedures, and that this information could conceivably influence activity levels and patterns at their facilities.

  • Digital Strategy and Social Media Essentials for Anesthesiologists: ‘Lead or Be Left Behind’

    November 26, 2018

    Social media can be a powerful tool to help you reach your professional goals, whatever they may be. We provide an overview of a presentation by Marjorie Stiegler, MD, on digital strategy for physicians at ANESTHESIOLOGY® 2018.

  • 2019 Physician Fee Schedule: Highlights for Anesthesia Providers

    November 19, 2018

    The national anesthesia conversion factor for the 2019 Physician Fee Schedule final rule increased minimally to $22.27 from $22.19 in 2018.  We review highlights of the 2019 rule with relevance for anesthesia providers, including changes to the Quality Payment Program for payment year 2021.  Significant changes in documentation requirements for E&M services were finalized for 2019. We are analyzing these changes and will discuss their implications for anesthesia practitioners in a future eAlert.

  • The 2019 OPPS/ASC Payment Rule: Implications for Anesthesia Groups

    November 12, 2018

    The 2019 OPPS/ASC final rule adds 12 cardiac catheterization procedures and five additional cardiology procedures to the ASC list of covered procedures. As a result, many anesthesia groups will see a change in the mix of procedures at their ASCs starting in 2019 and should begin planning accordingly.

  • Anesthesia Groups: Build a Healthier Environment to Combat Burnout

    November 5, 2018

    The current framework for addressing burnout, including burnout among physicians and other healthcare professionals, tends to be one that attempts to ‘fix’ the individual, but burnout is really a warning sign to the organization that it needs to make improvements in the social and psychological environment. We offer highlights of a presentation by Dr. Christina Maslach at ANESTHESIOLOGY® 2018.

  • Telemedicine in Anesthesia: Perioperative Medicine’s Newest Disruptor?

    October 29, 2018

    The use of telemedicine to streamline care, reduce costs without compromising quality, and enhance patient satisfaction and engagement among a highly technology-connected population of healthcare consumers shows promise in the delivery of perioperative services. We offer highlights of a presentation on telemedicine in anesthesia at ANESTHESIOLOGY® 2018 in San Francisco.

  • Anesthesia Roads Less Traveled: Paths to Executive Leadership Positions

    October 22, 2018

    Among the offerings at ANESTHESIOLOGY® 2018 was a panel discussion by three anesthesiologists who have made the successful transition to executive leadership roles in healthcare administration, industry and public policy.  We highlight selected comments from the panelists and ASA resources for members interested in pursuing various kinds of leadership opportunities.

  • Network Adequacy and Access to Anesthesia Care

    October 15, 2018

    The Texas Department of Insurance recently fined insurer Humana $700,000 for failing to contract with a sufficient number of anesthesiologists to ensure that patients had the ability to receive their anesthesia care from in-network providers.  Some patients had received “surprise” medical bills as a result of the insurer’s failure to comply with the state’s network adequacy laws.  We provide an overview of network adequacy and its significance for anesthesia groups.

  • Anesthesia Practitioners, Pain Specialists and the New Joint Commission Ambulatory Care Pain Requirements

    October 8, 2018

    The new and revised Joint Commission standards for pain assessment and management for ambulatory care, critical access hospitals and office-based surgeries will go into effect in January 2019.  Anesthesia groups should review their departmental policies and procedures and modify them as needed to ensure compliance.

  • Anesthesia for Endoscopy: Economics 101

    October 1, 2018

    Following dramatic growth in the provision of—and reliable reimbursement for—anesthesia services by an anesthesiologist or nurse anesthetist for endoscopic procedures, we are seeing isolated payer policy changes intended to limit utilization. We predict similar changes from other key payers. We advise anesthesia practices that are expanding their endoscopy service to continue, but with close monitoring of productivity and reimbursements. ABC clients interested in a detailed analysis are invited to contact their account executives.

  • Insights for Anesthesia Practitioners on Wrong-Site Nerve Blocks

    September 24, 2018

    Though rare, wrong-site nerve blocks are much more common than wrong-site surgery, according to a large incidence study.  Two organizations, the Pennsylvania Society of Anesthesiologists and the Pennsylvania Patient Safety Authority, joined forces to develop a consensus-based, peer-driven protocol that incorporates practices with unique relevance for the perioperative team.

  • What Is Agile and What Can It Do for Anesthesia?

    September 17, 2018

    Agile improvement methods based on an iterative project management approach first used in the software industry can be applied to a variety of problems in healthcare, including those related to anesthesia care. We review key characteristics of the Agile approach and offer examples from the scientific literature.

  • Current Data on Anesthesiologist Compensation

    September 10, 2018

    We summarize findings on anesthesiologist compensation from the Medscape Anesthesiologist Compensation Report 2018.  The survey reports total annual compensation for anesthesiologists of an average of $386,000, a six percent increase from the 2017 report.  A multitude of factors are used to determine compensation, and actual compensation figures among anesthesiologists can vary widely.

  • Acute Pain Management: The CPT Coding Challenge for Anesthesia

    September 4, 2018

    The growing use of nerve blocks for acute pain management is helping anesthesiologists improve the quality and safety of patient care.  New approaches and techniques are emerging all the time.  While this innovation benefits patients, it also creates billing and coding challenges and underscores the importance of having a billing partner that understands this area and stays current with changes in the CPT® Codebook.

  • Burnout in Anesthesia: Targeting Causes, Solutions and Prevention

    August 27, 2018

    Physician burnout—including burnout among anesthesia providers—remains a serious public health problem, with studies showing prevalence rates of approximately 50 percent.  A recent study in the Journal of Internal Medicine calls for a two-pronged blend of individual and organizational solutions, arguing that “addressing physician burnout should be viewed as a shared responsibility across healthcare systems, organizations, institutions and individual physicians.”

  • Anesthesia and Pain Clinicians: Know When—and When Not—to Issue an Advance Notice of Noncoverage

    August 20, 2018

    When an anesthesia or pain management service that is usually covered by Medicare or another insurer may not be covered in a given circumstance, practitioners must issue an advance beneficiary notice (ABN) describing the services and informing the patient of their potential financial responsibility if they choose to proceed.  Failure to appropriately issue an ABN can result in financial liability for the anesthesia or pain management provider.

  • Artificial Intelligence and Machine Learning in Anesthesia: Are We There Yet?

    August 13, 2018

    Within five years, more than half of hospitals will have begun using artificial intelligence, including machine learning, to support clinical care and business functions, a survey has found.  We offer current information on the emerging technology’s expansion and acceptance in medicine and healthcare, along with insights on potential applications in anesthesia.

  • CMS’s 2019 Anesthesia-Related Payment Proposals for Outpatient and Ambulatory Services

    August 6, 2018

    The proposed rule for the Outpatient Prospective Payment System and the Ambulatory Surgery Center Payment System for 2019 includes proposals to change payment policy for non-opioid postsurgical pain management drugs, expand reimbursement for anesthesia services for some knee surgeries to outpatient settings and remove questions about pain communication from patient surveys.

     

  • Will Anesthesia Providers be Targeted in CMS’s ‘Probe and Educate’ Audits?

    July 30, 2018

    Targeted Probe & Educate, a medical review process introduced by the Centers for Medicare and Medicaid Services in late 2017, identifies providers with high claim error rates or unusual billing practices for items and services that pose the greatest financial risk to Medicare.  We present an overview of the process, which focuses on educating providers as a means of reducing claims denials.

     

  • CMS’s 2019 Proposed Payment Rule: Highlights for Anesthesia and Pain Management Providers

    July 23, 2018

    The proposed Medicare Physician Fee Schedule for 2019 includes a slight increase in the anesthesia conversion factor as well as some changes to the Quality Payment Program and a significant overhaul of documentation requirements for Evaluation & Management services.  CMS is accepting comments on the proposal until September 10, 2018.