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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May 8, 2017
The Advanced Institute for Anesthesia Practice Management (AIAPM), held the weekend before last in Las Vegas, offered anesthesiologists and CRNAs a wealth of practical advice on surviving and thriving in a complex and uncertain healthcare environment.
May 1, 2017
If, like most anesthesiologists and CRNAs, you are participating in the Merit-Based Incentive Payment System (MIPS) arm of the Quality Payment Program (QPP), you are probably aware of the various methods available for submitting data. Two of the most important of these for anesthesiologists and CRNAs are the Qualified Registries (QRs) and the Qualified Clinical Data Registries (QCDRs) developed by third-party vendors that require approval by the Centers for Medicare and Medicaid Services (CMS).
April 24, 2017
Considering the rigorous demands, complexity and pace of modern anesthesia practice, it’s not surprising that many anesthesia groups chronically delay thinking about succession planning. Your group’s plate is already full dealing with everything in the here and now, from cybersecurity threats to MACRA compliance. Succession planning doesn’t demand your attention at the moment, so why think about it when countless other, more pressing issues compete for your time?
April 17, 2017
The unwholesome cocktail of cynicism, exhaustion and feelings of inefficacy and apathy that has become universally known as burnout afflicts at least half of physicians. And it is definitely an affliction, with far-reaching implications, not only for the distressed individuals, but also for the quality of care, patient safety, healthcare costs, physician turnover and patient satisfaction. Organizations tend to under-discuss it, but it’s not an issue that hospitals, health systems or individuals can disregard. A March 28, 2017 article on the Health Affairs blog by 10 health system CEOs calls burnout a national public health crisis and “a matter of absolute urgency.”
April 10, 2017
The specialty of anesthesia is in a constant state of evolution as practitioners seek new modalities to safely manage patients through the discomfort and trauma of surgery. As providers experiment with new procedures, such as nerve blocks for postoperative pain management, ultimately, each new modality is evaluated on three levels: technical expertise, clinical efficacy and financial viability. The use of interscalene blocks for the management of postoperative pain associated with painful shoulder procedures provides us with a useful case study, highlighting the various prerequisites for a successful rollout of a new modality.
April 3, 2017
The Medicare Access & Chip Reauthorization Act of 2015 (MACRA) marked the end of Medicare payment’s fee-for-service model and the beginning of a performance-based payment system, the Quality Payment Program (QPP). Understanding how participation in the QPP will impact your payments begins with understanding the scoring system.
March 29, 2017
Fee-for-service has been the traditional methodology for reimbursements, but as CMS transitions to a pay-for-performance methodology, it is easy to get lost in the acronyms and the policy.
March 27, 2017
Recent data regarding opioid-related deaths tell some harsh truths about the depth of opioid addiction in the United States. In December, the Centers for Disease Control and Prevention (CDC) reported that the number of overdose deaths involving opioids rose from 28,647 in 2014 to 33,091 in 2015—an increase of nearly 5,000 deaths and the first time deaths in one year exceeded 30,000.
March 20, 2017
The House proposal to “repeal and replace” the Affordable Care Act (ACA), the landmark and controversial legislation that is a signature of President Barack Obama’s administration, indicates that the nation’s healthcare system could be heading for yet another upheaval. Tomorrow (March 21, 2017) marks the seventh anniversary of the ACA. Although there is still a high degree of uncertainty regarding what the final repeal-and-replace legislation will look like, or when it will appear, any changes to the ACA will have important implications for hospitals, health systems and healthcare professionals—anesthesiologists and nurse anesthetists included—as well as for patients.
March 13, 2017
The fact that 125,000 fewer patients died due to hospital-acquired conditions in 2010-2015, resulting in a cost savings of more than $28 billion, shows healthcare’s capacity for large-scale improvement. Anesthesia’s long history of safety improvements and innovations includes some significant recent safety gains as well. The percentage of anesthesia-related adverse events dropped from 11.8 percent to 4.8 percent of procedures between 2010 and 2013, according to the Anesthesia Quality Institute’s (AQI) National Anesthesia Clinical Outcomes Registry (NACOR) of more than 3.2 million anesthesia cases.
March 6, 2017
While many anesthesia practices are struggling to survive, others are thriving as they embrace the new challenges facing the specialty. The American Society of Anesthesiologists’ Conference on Practice Management offered an excellent forum for the discussion of new ideas in this regard. Today’s eAlert comes from the presentation by Daniel Cole, MD, immediate past president of the ASA.
February 27, 2017
Given the pace of change in healthcare—anesthesia included—and the challenges associated with negotiating an appropriate and reasonable stipend for your practice, the possibility always looms that if your anesthesia group can’t come to an agreement with your institution, of if your hospital system wants to employ all physicians, you will face hospital employment. The good news is that this doesn’t happen very often with anesthesia. Nevertheless, it remains a concern.
February 20, 2017
- An endoscopy nurse drops syringes of fentanyl into a secret pocket in her uniform top and substitutes them with syringes containing saline.
- A radiology technician with hepatitis C diverts unused fentanyl syringes intended for patients and five patients become infected with the virus. One of the patients eventually dies from the infection.
- A night custodian rummages through sharps waste containers and consolidates minuscule remaining fentanyl vials for his own use.
February 13, 2017
Over the past decade or so, endoscopy has become a significant line of business for most of the country’s anesthesia practices. Much empirical evidence has supported the role of anesthesia in the endoscopy center. Outcomes are more consistent, patients are more comfortable and endoscopists can be more productive.
February 6, 2017
As healthcare’s transition to value-based care via MACRA and the Quality Payment Program continues unabated, so do efforts by anesthesia practices to solidify their relationships with their hospitals and find new ways to demonstrate value.
January 30, 2017
A study by the Office of Inspector General (OIG) has revealed “vulnerabilities” under the Two-Midnight hospital policy that initially went into effect on October 1, 2013. In response to the findings, OIG has recommended that the Centers for Medicare and Medicaid Services (CMS) improve oversight of hospital billing under the policy and take steps to increase protections for beneficiaries. Anesthesiologists should be aware that their hospitals are likely to see closer scrutiny to determine whether physicians are appropriately characterizing inpatient and outpatient stays.
January 23, 2017
Nitrous oxide for labor analgesia is used widely in some European countries, Australia, New Zealand and Canada, but relatively rarely in the United States. It was available in the U.S. at one time, but virtually disappeared in the 1970s with the development of neuraxial anesthesia. This appears to be changing. The inhalational agent has seen an upswing in interest among women and clinicians in recent years.
January 16, 2017
Search the professional literature and reputable web sources on the topic of medical marijuana (cannabis) and the consensus seems to be the existence of an over-arching lack of consensus on use of the substance as a treatment modality.
January 9, 2017
As part of our continuing efforts to keep you informed of developments that could have an impact on your practice, we present the following summary of coding and reimbursement changes for 2017, along with related documentation reminders.
January 3, 2017
We start the new year with warm wishes and a compilation of updates and practical information gathered from some of our most reliable sources.
December 27, 2016
Looking back on 2016, one need only look as far back as November to find the year’s most significant regulatory development. Donald J. Trump’s election as president and his vow to repeal the Affordable Care Act (ACA) of 2010 have triggered a mountain of speculation about the fate of the historic and controversial legislation, a hallmark of President Barack Obama’s administration.