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 ...

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...

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...

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...

When most practice administrators started in anesthesia billing operations, collecting for services was markedly different than it is today, even if you are relatively new to the special. There are a variety of factors including government regulations, The Patient Protection and Affordable Care Act of 2009 (ACA), bundled payments, high deductible h...

SUMMARY Anesthesia Business Consultants anticipates that most of its clients will be prepared to participate in the "partial" reporting option during the first year of the Merit-Based Incentive Payment System of the Quality Payment Program mandated by the Medicare Access and CHIP Reauthorization Act (MACRA). In our view, this option offers the most...

Article courtesy of SurveyVitals CEO, Bob Vosburgh.​ Why Track the Patient Experience? For every patient who expresses dissatisfaction or voices concern, there are nine or ten more who keep quiet.1 However, dissatisfied patients are often some of the most vocal. They are likely to tell at least 20 people about their experiences or go to an onl...

SUMMARY Postoperative delirium (POD) is a significant problem in elderly patients, and yet the complication is also preventable in many cases. Anesthesiologists are leading the way in the prevention of POD in older surgical patients through the Brain Health Initiative of the American Society of Anesthesiologists and with the development of effectiv...

Press releases following a publication in the British Medical Journal (BMJ) hysterically echoed the article's headline: "Medical error—the third leading cause of death in the U.S."1 The authors used a variety of published sources on the incidence, lethality and preventability of medical errors to produce an estimate of 251,000 deaths per year attri...

SUMMARY Although adverse events in anesthesia are relatively rare, they do happen. The Agency for Healthcare Research and Quality (AHRQ) has developed a communication resolution program called CANDOR (Communication and Optimal Resolution) that gives clinicians and healthcare organizations a framework for responding promptly and fairly to harmful ev...

The Mark F. Weiss Law Firm, Dallas, TX, Los Angeles and Santa Barbara, CAI 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 anesthesi...

SUMMARY The perioperative surgical home (PSH) offers anesthesia providers an excellent opportunity to add value to their institutions and practices as healthcare moves from a volume-based to a value-based model, according to presenters at ANESTHESIOLOGY® 2016. Hallmarks of an effective implementation include strong multidisciplinary collaboration, ...

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...

SUMMARY Emergency manuals as cognitive aids in perioperative settings show promise as a safety improvement tool, according to a Stanford University anesthesiologist who spoke at ANESTHESIOLOGY® 2016. The key to successful implementation is a culture that embraces cognitive aids not as a sign of clinical incompetence, but as a tool to improve care.I...

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...

SUMMARY In his keynote address at ANESTHESIOLOGY® 2016, Michael E. Porter puts forth his vision for value-based healthcare and the need for anesthesiologists to reorganize the way they practice, stretch their involvement in the care cycle, practice at the top of their license, measure value by measuring outcomes, embrace bundled payments and use an...

For years, anesthesiologists have been acutely aware that this country's healthcare reimbursement regime is in a state of significant transition. Government healthcare programs (such as Medicare and Medicaid) and commercial payers are gradually moving away from a fee-for-service model to value-based payment programs that focus on the quality and ef...

SUMMARY The incidence of surprise billing is increasing, as is the introduction and passage of state legislation to protect patients from potentially devastating medical expenses. Surprise billing legislation passed recently in California, set to go into effect in 2017, is likely to trigger a wave of heightened activity at the state level. A new Br...

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 above and beyond the tangible assets or the net present value of your group's future cash flows. For example, good will was a substantial portion of th...

SUMMARY An innovative anesthesiologist-driven transitional pain service shows promise as a model for preventing and managing the significant problem of chronic postsurgical pain (CPSP). The service focuses on early identification and multidisciplinary intervention before, during and after hospitalization for patients at risk for CPSP, and could pro...