The Challenge of Change

Today’s healthcare market is in a very dynamic stage. On the one hand, there are so many exciting medical developments; clinicians are truly conquering some of the world’s most serious challenges. Cancer and AIDS are probably our two most dramatic success stories. In anesthesia the use of targeted nerve blocks may allow us to beat back the opioid crisis. What used to be a death sentence is now just an inconvenience.

Unfortunately, the flip side of the coin is the cost of healthcare. Despite all the rhetoric, there does not appear to be a good solution. As a result, every healthcare organization must now focus on ways to reduce the cost of diagnosis and treatment. This affects hospitals and, especially, their review of stipend requests from anesthesia departments. This affects anesthesia practices in a very significant manner as they struggle to recruit and retain sufficient providers to meet every expanding hospital expectations.

To this end, our lead article discusses the current trends in CRNA care and the potential of new models of team management. What was introduced as an arcane Medicare billing modifier has become one of hottest topics in the specialty. Howard Greenfield, MD and ABC’s own Jody Locke, MA, vice president of anesthesia and pain practice management services have compiled a very thorough review.

Attorney Mark F. Weiss, JD, of the Mark F. Weiss Law Firm, always has some interesting insights to guide us through the myriad challenges on negotiating a fair contract. Increasingly it is our negotiating skills that determine our success or failure in medicine and not the quality of service provided.

Another attorney, Kathryn Hickner, Esq., of Kohrman, Jackson & Krantz, LLP, then delves into the every intriguing issue of practice mergers and acquisitions. How big is big enough? Her observations are especially salient to the current environment.

First time Communiqué author Nirav Kamdar, MD, MPP, with the Department of Anesthesiology and Perioperative Medicine at UCLA, then takes us into the fascinating realm of telemedicine. Some very exciting things are happening at UCLA. We are always interested in looking into the future of anesthesia. In today’s competitive healthcare arena innovation may well differentiate winners from losers.

Finally, our always reliable anesthesia consultant, Kelly D. Dennis, MBA, of Perfect Office Solutions, Inc., brings us back to reality with a very careful and exhaustive review of today’s anesthesia documentation requirements. If ever you were wondering how complicated anesthesia billing has become, this is a worthy explanation. It should be mandatory reading for all providers.

There is never a shortage of hot topics in anesthesia. We are constantly seeking useful and reliable solutions to today’s most pressing problems. I hope you find our ideas timely and relevant. Please let us know how they may be helpful to you and what challenges you are currently facing.

We look forward to seeing many of you at ANESTHESIOLOGY® 2019 in Orlando.

With best wishes,

Tony Mira
President and CEO