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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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What is the Future of Private Anesthesia Practice?

Jody Locke, MA, Vice President of Anesthesia and Pain Practice Management Services Anesthesia Business Consultants, LLC, Jackson, MIMany anesthesia providers look at the changes taking place in the specialty and shake their heads. Today's practices bear little or no resemblance to practices of 10 or 20 years ago. Who could have envisioned groups wi...
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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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Anesthesia and Pain Clinicians: Know When—and When Not—to Issue an Advance Notice of Noncoverage

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

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...
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The Winning Strategy for Billing Invasive Monitoring

When the ASA Relative Value Guide (RVG) was first developed in the 1970s it established a significant precedent with regard to what services could be billed as incidental to an anesthetic. The guide established the concept of "invasive" as the critical criterion.Arterial artery catheters, known as A-lines; central venous catheters; and Swan-Ganz ca...
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CMS’s 2019 Anesthesia-Related Payment Proposals for Outpatient and Ambulatory Services

SummaryThe 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 co...
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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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Will Anesthesia Providers be Targeted in CMS’s ‘Probe and Educate’ Audits?

SummaryTargeted 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 educa...
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The Winning Strategy for Billing Invasive Monitoring

Kelly D. Dennis, MBA, ACS-AN, CANPC, CHCA, CPC, CPC-I Perfect Office Solutions, Inc., Leesburg, FL When the ASA Relative Value Guide (RVG) was first developed in the 1970s it established a significant precedent with regard to what services could be billed as incidental to an anesthetic. The guide established the concept of "invasive" as the critica...
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CMS’s 2019 Proposed Payment Rule: Highlights for Anesthesia and Pain Management Providers

SummaryThe 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. The ...
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What is the Right Compensation for Your Providers?

Jody Locke, MA Vice President of Anesthesia and Pain Practice Management Services Anesthesia Business Consultants, LLC, Jackson, MIMany anesthesia practices complain that their biggest challenge is to generate enough funds to cover the cost of a sufficient number of providers to meet the expectations and service requirements of the facilities they ...
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Adding Focus and Structure to Anesthesia Patient Handoffs

SummaryPatient handoffs are a significant source of errors in intraoperative and perioperative settings. Efforts to reduce these errors often succeed at first, but do not result in behavior change that lasts. A highly structured six-stage patient handoff implementation strategy developed at Midland Memorial Hospital in Texas has reduced handoff err...
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