February 5, 2018

The theme of the American Society of Anesthesiologists’ (ASA) practice management conference in New Orleans was “Navigating for Success,” and, as clearly shown in several sessions throughout the meeting, quality measurement and data that demonstrate value to facilities and government and private payers are quickly gaining significance as navigational tools.

An increasingly important aspect of demonstrating quality and value is surveying patients and showing that they have had positive experiences with their anesthesia care, according to James R. Mesrobian, MD, FASA, an ASA board member and member of the Committee on Practice Management, who spoke at the meeting.

This growing emphasis on measuring patient satisfaction with anesthesia is being driven by, among other things, the transition to value-based care mandated by the Medicare Access and CHIP Reauthorization Act (MACRA) and MACRA’s Merit-Based Incentive Payment System (MIPS), as well as by the precedent set by the Hospital Consumer Assessment of Healthcare Providers and Systems (H-CAHPS) surveys. 

In addition, though it is a work in progress, the Centers for Medicare and Medicaid Services’ Physician Compare website is moving toward implementation of a user-friendly, consumer-oriented five-star system in which anesthesiologists and anesthetists will be rated based primarily on the quality data they report.

The healthcare sector’s movement toward these types of data and ratings for use by patients, payers and providers signals that it is definitely time for anesthesia groups to enter the fray, said Dr. Mesrobian.  Healthcare organizations and payers are increasingly using information about patient perceptions and satisfaction to help them make decisions about the groups with whom they partner. Anesthesia departments that climb on board with satisfaction surveys are more likely to gain an important competitive advantage.

Patient satisfaction measures are included in both the Quality and the Improvement Activities components of MIPS.  

Statistically valid patient satisfaction tools as measures of anesthesia quality aren’t widely available, but they’re really beside the point, because patients cannot truly assess clinical quality, Dr. Mesrobian said.  However, what they can assess is their satisfaction with the anesthesia provider’s communication and service, which has great value in itself.  The ability for anesthesia departments to show patient satisfaction with these aspects of anesthesia care can strengthen their relationships with their hospitals and health systems, he said.

Though “most standard survey tools aren’t valid statistically or psychometrically to assess quality of care, I think there are other benefits of doing this in terms of value to our patients and to us,” Dr. Mesrobian said.  “I think it gives us a huge competitive advantage to know this from our patients. Surgeons and administrators recognize practices that do versus those that don’t.  It also demonstrates a commitment to the patient, reinforces positive physician behavior among your staff and can be used to report under MIPS.”

He noted some other tactics that anesthesia practices of any size can use to measure and improve patient satisfaction, such as adding an anesthesia-specific question to a hospital’s or surgery center’s existing patient satisfaction survey, and developing formal departmental policies and offering training in communication for anesthesia staff.  “We don’t know where the future lies, but service is increasingly a part of what we do,” he said.

In our view, it is definitely time for anesthesia practices to control their own destiny in this realm by developing and conducting their own surveys of patient satisfaction with anesthesia service and communication.  

For more information, also see Patient Satisfaction and Experience with Anesthesia, ASA Committee on Performance and Outcomes Measurement, 2014.

With best wishes,

Tony Mira
President and CEO