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Anesthesia Mergers and Acquisitions and Post-Termination Obligations: Have You Terminated Your Future?

I pushed the wiring instructions across the table.A few minutes later, I confirmed that close to $10 million was in the account of my client, the sole shareholder.Then we all went to lunch.Ah, the shiny object, the more or less instant gratification. The sale of your anesthesia group and the fresh $1 million in your pocket.But what comes next? And ...
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The American Health Care Act: An Overview for Anesthesia Practitioners

SUMMARY Efforts by Congress and the Trump administration to repeal and replace the Affordable Care Act are far from over, and the impact on patients, hospitals and healthcare providers, including anesthesia practitioners, is still not known. We summarize the provisions of the American Health Care Act and responses from major healthcare organization...
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What Anesthesiologists Need to Know About Enforcement of Non-Compete Agreements

Amanda K. Jester, JDWaller Lansden Dortch & Davis, LLP, Austin, TXAshleigh VanLandingham, JDWaller Lansden Dortsch & Davis, LLP, Nashville, TNOn May 5, 2016, the White House issued a report citing a variety of issues with the use of non-compete agreements advocating for non-compete reform at the state and federal level.1 According to the Wh...
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11 Building Blocks of a Safety Culture in Anesthesia—and Beyond

SUMMARY Without sustained efforts by healthcare leaders—including anesthesia leaders—to foster a culture that lives and breathes patient safety, organizations and practices cannot change, according to Ana Pujols McKee, MD, of The Joint Commission. We highlight 11 Tenets of a Safety Culture, issued in a recent Sentinel Event Alert, all of which depe...
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Hope Is Not a Strategy: A Primer for Anesthesia Groups on Strategic Planning

One of the most important responsibilities of any anesthesia group's governance is to develop a strategic plan for the group. For some groups this is the role of the Board. In other groups, all shareholders participate in this process.Unfortunately, it appears that for many groups, "hope" is their strategy.We are continually surprised to find group...
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Anesthesiologists: Innovate and Anticipate the ‘Next Play’ to Lead the Specialty’s Move to Value-Based Care

SUMMARY Anesthesiology is in the midst of a 'Blockbuster-Netflix moment,' according to Daniel Cole, MD, immediate past president of the American Society of Anesthesiologists. By focusing on innovation and opportunities for system performance improvement, and with insight into their own leadership styles, anesthesiology leaders can help the professi...
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What Impact Could ICD-10 Really Have on Anesthesia?

On October 1, 2015, a major change to diagnosis coding was rolled out with the International Classification of Diseases and Health Related Problems 10th revision (ICD-10), and virtually all payers (except workers compensation and auto carriers) have agreed to implement the new codes. There was serious concern that the complexity of the new code seq...
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Negotiating a Hospital Employment Contract: Smart Tips for Anesthesia Providers

SUMMARY Although our experience tells us that anesthesiologists and anesthesia groups are less likely than other specialty groups to become hospital employees, it's important to know what you could be facing should you find yourself in the situation of needing to negotiate an employment agreement. We highlight some of the takeaways from a presentat...
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Electronic Medical Records in Anesthesia: Who Will Benefit and How?

The concept of automating the anesthesia record has intrigued academicians for decades. Some of the early versions of software packages for computer-based record keeping were quite complete and impressive despite the technology's limitations during the 1980s and 1990s. A number of companies made significant investments in the various software optio...
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Hospital Drug Diversion Prevention: Strategies for Anesthesiologists, Nurse Anesthetists and Chronic Pain Specialists

SUMMARY The Drug Enforcement Agency and other agencies are scrutinizing hospitals and healthcare facilities more closely for failure to implement and maintain appropriate drug diversion prevention policies, procedures and programs, and they are holding organizations as well as individuals responsible. As professionals who manage and administer a la...
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The ACA’s Impact on Healthcare Payment

Maurice Madore, MBA, CPC Chief Client Officer, Anesthesia Business Consultants, Jackson, MIWhen the Affordable Care Act (ACA) was signed into law in 2010, it set into motion a series of intended and unintended actions and consequences that, after several years, can now be reviewed and interpreted. According to the Centers for Disease Control and Pr...
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What Anesthesia Practitioners Should Know About GI Procedures for 2017

SUMMARY Downward pressure on payment to endoscopists based on the 2017 Physician Fee Schedule final rule continues to raise questions about the viability of the symbiotic relationship between anesthesia providers and endoscopists. At the same time, though colonoscopy is still considered the gold standard, less invasive techniques for colorectal can...
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Switzerland and the Anesthesia Group Structure

Mark F. Weiss, JD The Mark F. Weiss Law Firm, Dallas, TX, Los Angeles and Santa Barbara, CAQuick! Who's the president of Switzerland?Anesthesia group leaders seeking to create a larger structure out of existing groups, from an alliance among local groups, to business models for exclusive contracting, to the creation of a true regional or national p...
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Adding Value in the ICU: The Case for Anesthesiologist Leadership

SUMMARY Anesthesiologists are exploring new opportunities to demonstrate value to their hospitals, both inside and outside of the operating room. Leadership of the intensive care unit provides an option that some practices might want to consider. Critical care medicine is, in many ways, a logical extension of anesthesia practice and can also provid...
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Hope Is Not a Strategy: How to Create Your Strategic Business Plan

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TNIn the previous issue of The Communiqué ("Hope Is Not a Strategy: A Primer for Anesthesia Groups on Strategic Planning," Fall 2016) we described the need for strategic planning and described the overall process. This process includes: Developing mission and vision statements ...
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OIG Report Reveals Two-Midnight Rule Vulnerabilities: An Update for Anesthesia Providers

SUMMARY A recent claims analysis by the Office of Inspector General has revealed "vulnerabilities" in the Two-Midnight rule, a policy implemented in 2013 to contain healthcare costs, improve the accuracy with which physicians characterize inpatient and outpatient hospital stays, and reduce the number of long outpatient stays. Among other things, th...
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The MACRA Quality Payment Program Is Here. Are You Ready?

You have heard of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and, most likely, its Quality Payment Program (QPP). But do you really know what it is? Do you know what it means to your practice? Do you know what your practice will need to do to thrive under the QPP? If you haven't already, you'll need to develop a firm understan...
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Nitrous Oxide in Obstetric Anesthesia: Yes or No?

SUMMARY Nitrous oxide for the management of labor pain is experiencing a rebirth in labor and delivery suites across the United States. Still, despite the increased interest, debate regarding nitrous oxide's advantages, as well as its potential adverse effects on women, newborns and healthcare workers, is ongoing. We present evidence from the Socie...
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Hope Is Not a Strategy: A Primer for Anesthesia Groups on Strategic Planning

One of the most important responsibilities of any anesthesia group's governance is to develop a strategic plan for the group. For some groups this is the role of the Board. In other groups, all shareholders participate in this process.Unfortunately, it appears that for many groups, "hope" is their strategy.We are continually surprised to find group...
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Medical Marijuana in Anesthesia and Chronic Pain Practice: Where Are We Now?

SUMMARY Medical marijuana has become legal in 28 states and Washington, D.C., and yet the Drug Enforcement Administration continues to classify botanical marijuana as a Schedule I drug with "no accepted medical use in treatment." This classification has limited access to the drug for research purposes. For this and other reasons, the use of medical...
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