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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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The Perioperative Surgical Home: Preoperative Risk Stratification, Optimization and Value

Payers, patients and partners are demanding better outcomes, and evolving healthcare paradigms are begging for greater anesthesia engagement. If you have been following this series, then you already know that the perioperative surgical home (PSH) is the answer to the call and the future of our specialty. What you may not know is how easy it can be ...
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2017 Coding Changes That Could Affect Your Anesthesia or Chronic Pain Practice

SUMMARY We highlight changes to the 2017 CPT® Standard Codebook that are of special interest to anesthesia and chronic pain practitioners. We encourage you to review these changes carefully and contact your ABC Vice President or Director with any questions. As part of our continuing efforts to keep you informed of developments that could have an im...
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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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News Anesthesia Practices Can Use in 2017: On Language Services, HIPAA, Recycling and the FTC

SUMMARY What you need to know about language services and the Affordable Care Act, HIPAA and public health activities, recycling in the OR, the FTC Act and Medicare's Social Security number removal initiative. We start the new year with warm wishes and a compilation of updates and practical information gathered from some of our most reliable source...
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Preparing for Round 2 of HIPAA Audits

Over the past five years, the Department of Health and Human Services Office of Civil Rights (OCR) has been more aggressive about identifying organizations that fail to comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its impending regulations. Historically, OCR has taken a reactive approach to noncompliance t...
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Healthcare Highlights of 2016—and Predictions for the New Year

SUMMARY That a new administration will take steps in 2017 to repeal the Affordable Care Act (ACA) is fairly certain, but eligible anesthesia providers should forge ahead with their plans to report under the Quality Payment Program mandated by the Medicare Access and CHIP Reauthorization Act (MACRA). Regardless of what happens to the ACA, MACRA and ...
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The Perioperative Surgical Home: Invest in Good Will

Rick Bushnell, MD, MBADirector, Department of Anesthesia, Shriners Hospital for Children, Los Angeles, CAand Huntington Memorial Hospital, Pasadena, CA You trade on it every day. It may be your anesthesia group's most important asset. It's difficult to quantify, but in the accounting sense, "good will" is the value of your anesthesia group's assets...
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What Do We Really Know About ICD-10’s Potential Impact 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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Use Lean Six Sigma to Enhance ‘Flow,’ Add Value to Anesthesia Care

SUMMARY The rigorous process improvement methodologies known as Lean and Six Sigma have countless applications in healthcare and have been used to improve many aspects of anesthesia care. Anesthesia providers might want to consider employing these approaches in their quality improvement efforts. Hospitals and healthcare practices have used the Lean...
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