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Tony Mira, Chairman and Chief Executive Officer of MiraMed

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Tony Mira founded MiraMed Global Services, Inc. in 2005 and serves as its Chairman and Chief Executive Officer. Mr. Mira also Co-Founded MiraMed's subsidiary Anesthesia Business Consultants, LLC in March 2001 and serves as its Chairman and Chief Executive Officer. By bringing these companies together under the MiraMed moniker, he has formed one of the largest healthcare Business Process Outsourcing (BPO) companies in the United States.

Will You Join Us In Helping the Homeless This Holiday Season?

Working Together to Raise Money to Provide 1,000 Coats!The MiraMed Family of Companies has created the MiraMed Circle of Warmth Campaign and partnered with an exceptional project called the Empowerment Plan, a Detroit-based nonprofit organization focused on permanently elevating families from the generational cycle of homelessness. The project hire...
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An Update on Evaluation and Management Coding for Anesthesia Providers

Summary: 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...
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How Will Price Transparency Impact Anesthesia Practices?

Summary: 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.In a previous eAlert, w...
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Digital Strategy and Social Media Essentials for Anesthesiologists: 'Lead or Be Left Behind'

Summary: 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.In 2013, 350 people on Twitter generated 220,000 "impressions" related to the ASA scientific meeting using the eve...
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2019 Physician Fee Schedule: Highlights for Anesthesia Providers

​Summary: 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...
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The 2019 OPPS/ASC Payment Rule: Implications for Anesthesia Groups

Summary: 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.The Centers for Medicare and Medicaid S...
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Becoming a Cheetah and Other Survival Tactics

In her blog, A Penned Point, early this year, Karen Sibert, MD, president of the California Society of Anesthesiologists, asked her fellow specialists to take some time during Physician Anesthesiologists Week to celebrate the specialty's accomplishments, but also to reflect on the state of the profession today, the anesthesiologist's place in the c...
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Anesthesia Groups: Build a Healthier Environment to Combat Burnout

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

​Summary: 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 ANESTH...
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Anesthesia Roads Less Traveled: Paths to Executive Leadership Positions

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 leadersh...
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Network Adequacy and Access to Anesthesia Care

SummaryThe 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 w...
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Anesthesia Practitioners, Pain Specialists and the New Joint Commission Ambulatory Care Pain Requirements

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.In June of this year, The Joint Com...
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Strength Means Service, Not Scale, in Today’s Anesthesia Market

A recent analysis of the financial information of 104 leading health systems (more than 2,200 hospitals) found that size and profitability do not necessarily go hand in hand. The report, by Navigant, throws into question the common wisdom that scale is required to deliver the effectiveness, cost efficiency, care coordination, physician recruitment ...
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Anesthesia for Endoscopy: Economics 101

​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 ...
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Insights for Anesthesia Practitioners on Wrong-Site Nerve Blocks

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 fo...
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A Refresher for Anesthesia Practices on Business Associate Agreements: Are Your Contracts in Order?

Covered entities, including anesthesia practices, are required under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to execute a contract with business associates to safeguard the privacy and security of protected health information (PHI). As the holder of the PHI, anesthesia groups should make sure they understand and carr...
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What Is Agile and What Can It Do for Anesthesia?

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.Does the word "agile" mean anything t...
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Current Data on Anesthesiologist Compensation

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 amon...
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Acute Pain Management: The CPT Coding Challenge for Anesthesia

SummaryThe 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 ...
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Burnout in Anesthesia: Targeting Causes, Solutions and Prevention

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 v...
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