Anesthesia Industry and Market News: eAlerts
eAlerts are the latest industry information regarding regulatory changes, helpful compliance reminders, or any number of relevant topics in the fast-paced, ever-evolving speciality of anesthesia.
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April 21, 2014
Interested parties can now look up how much Medicare paid each of more than 880,000 providers, including 32,641 anesthesiologists, 1,856 interventional pain physicians, 2,999 pain physicians, 30,160 nurse anesthetists and 881 anesthesiologist assistants individually by name.
Securing Anesthesiology’s Future, and Safeguarding its Present: Thoughts From the Advanced Institute for Anesthesia Practice Management
April 14, 2014
While we are all trying to understand how the landscape is evolving for anesthesiologists, nurse anesthetists and anesthesia groups, keeping our eyes on traditional practice management issues such as compliance remains as important as ever. Similarly, we must maintain a dual focus on the big picture of system and organizational changes, on the one hand, and on the day-to-day requirements of providing and being paid for anesthesia and pain medicine services, on the other. Our field of vision has to be both longitudinal and latitudinal.
April 7, 2014
When it comes to Medicare payments to physicians, plus ça change, plus c’est la même chose. Last week Congress adopted the 17th “patch” to prevent the huge cut mandated by the Sustainable Growth Rate (SGR) formula from going into effect for another year. The legislation also kept in place the antiquated ICD-9 coding system until at least October 1, 2015.
March 31, 2014
ICD-10 is coming, as we have all heard many times. Will full implementation be here on October 1, 2014, though, or on October 1, 2015? As of the time this is written, the Senate is expected quickly to take up the House-passed Protecting Access to Medicare Act of 2014 (H.R. 4302), legislation that will prevent Medicare payment cuts from going into effect on April 1st—and that contains a provision delaying the implementation of ICD-10 for a year. Whether we are six months or 18 months from the start date, however, it is none too early for clinicians to gain an understanding of what ICD-10 will require of them, as well as to practice meeting the new requirements.
March 24, 2014
Patients who receive an advance premium tax credit under the Affordable Care Act (ACA) may lose their insurance coverage if they fail to pay their premiums—and leave their providers holding the bag. With more than 4.2 million individuals now signed up for policies through the ACA health insurance exchanges, every provider is at some risk of loss. There are steps that anesthesia practices can take to avoid such losses.
March 17, 2014
More than one-third of the total cost of a hip or knee replacement can be attributable to the cost of the implantable device used in the procedure. In some cases, the device may account for up to 87 percent of the cost, according to a recent Health Affairs article that has attracted a good deal of attention (Okike K., O’Toole RV, Pollak AN, Bishop JA, McAndrew CM, Mehta S, Cross WW, Garrigues GE, Harris MB, Lebrun CT. Survey Finds Few Orthopedic Surgeons Know the Costs of the Devices They Implant. Health Aff (Millwood). 2014; 33(1):103-109. DOI: 10.1377/hlthaff.2013.0453).
March 10, 2014
The Affordable Care Act, which last week was the object of a fiftieth attempt at repeal in Congress, is moving the healthcare system toward greater integration of providers. Classic antitrust law, however, aims to increase competition and the number of competitors. The conflict between the two values finds it most recent expression in the January 24, 2014 decision in the St. Luke’s antitrust litigation in Boise.
March 3, 2014
Have you checked how your information appears on Medicare’s Physician Compare website? Is it accurate?
February 24, 2014
There are now more than 500 Accountable Care Organizations (ACOs) up and running in the U.S. Since they first appeared on the health care horizon, interest in their potential to improve quality while reducing or at least holding down costs has continued to grow. Specific approaches and strategies for shifting the quality/cost equation such as ASA’s Perioperative Surgical Home model are developing with a view toward participating in future ACOs. How—and how well—are ACOs working as the health care system’s transition to value-based care proceeds? Overall, the results are a mixed bag.
February 17, 2014
The Office of the Inspector General (OIG) in the Department of Health and Human Services released its Work Plan for 2014 on January 31, several months later than usual in part, at least, because of the sequestration and government shutdown engineered by our dysfunctional Congress last fall.
February 10, 2014
Leaders in medicine and health policy are focusing on a new component of care: appropriateness. Only those medical services and interventions that are likely to help and not harm the patient and that represent value (cost/quality) are appropriate. The real issue is, of course, knowing which services are appropriate.
February 3, 2014
No three-word phrase was heard more frequently than “Perioperative Surgical Home” (PSH) at the ASA Practice Management Conference held in Dallas on January 24-26, 2013.
January 27, 2014
After requesting comments from the public in August 2013 and receiving more than 130 letters, CMS is going forward with modification of its policy on disclosure of physician payment information.
January 21, 2014
Hardly a week goes by without news of the loss of a computer containing thousands of patient records. It is all too easy for medical practices and health systems to suffer data breaches, and the financial consequences can be severe. When a breach of patient data is found and reported, healthcare providers and legal business associates can be liable for penalties of up to $1.5 million for violations of a single HIPAA provision.
January 13, 2014
It is time for us to begin to familiarize ourselves with the role of telemedicine in anesthesiology. The concept is not entirely new; there have been several articles published on preadmission anesthesia or critical care consultations conducted through telemedicine. The results of a Canadian pilot study that appeared in Anesthesiology in 2004 showed “that preadmission anesthesia consultations using telemedicine technology can be successfully performed. Patients and consulting and attending anesthesiologists are very satisfied with telemedicine consultation.”
January 6, 2014
Anesthesiologists and other physicians who provided out-of-network services to Aetna patients for part or all of the period from 2003 to 2013 may be eligible for a share of the $120 million settlement agreement in the Aetna usual-and-customary (UCR) class action lawsuit.
December 30, 2013
Just like the physical universe, the anesthesia practice universe continues to expand with increasing speed—or at least that is how it seems. The number and breadth of the challenges we face are larger than ever. To the familiar concerns such as disappointing payment rates, declining hospital income support and growing service demands, we can add the confusion and worries created by Obamacare and explosion of work occasioned by information technology. In most challenges, we know, there are also opportunities, some more accessible than others, of course.
December 16, 2013
Electronic health records (EHRs) make it easier to document patient care with incorrect information, not just with desirable data. To put it bluntly, as does the Health and Human Services Office of the Inspector General (OIG) in its just-released report Not All Recommended Fraud Safeguards Have Been Implemented in Hospital EHR Technology, “Experts in health information technology caution that EHR technology can make it easier to commit fraud.”
December 9, 2013
The Centers for Medicare and Medicaid Services (CMS) released the 1369-page final regulations containing the changes to the Physician Fee Schedule for 2014 (the “Final Rule”) on the Wednesday before Thanksgiving. Updates and provisions of interest to anesthesiologists include the 2014 conversion factor and changes to the Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier requirements.
December 2, 2013
One of the longest-running Medicare whistleblower lawsuits, U.S. ex rel. El-Amin v. George Washington University (D.D.C. November 25, 2013), has apparently come to an end, without a trial. Late last month, the United States District Court granted the defendant’s motion for summary judgment, which means that even if the plaintiff’s factual allegations were true, the defendant would prevail as a matter of law.
November 25, 2013
One way in which anesthesiologists can add value to their hospitals’ bottom line is by assuming responsibility for the cost of the drugs they order and administer. The U.S. general anesthesia market size was approximately $2 billion in 2011 and is expected to grow at a moderate rate of 4% annually from 2011 to 2015, according to a Markets and Markets report. In addition, intravenous anesthetic drugs accounted for the largest share—65%—of the U.S. general anesthetics drugs market in 2011. Individual anesthesiology practitioners and groups have little control over total spending on drugs, just as they have little control over annual national spending on anesthesia services, but they can involve themselves in cost management locally, within their own institutions. As with most activities, success starts with knowledge.