Anesthesia Industry eAlerts
Sent to subscribers every Monday morning, our eAlerts deliver timely updates on regulatory, legislative and practice management developments of interest to anesthesia professionals.
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eAlerts
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It’s Vacation Time. Does Your Anesthesia Group Have the Right Coverage Using Locum Tenens?
July 7, 2014
It’s summertime and vacation plans are high on everyone’s list. Sometimes arranging coverage is difficult and groups resort to using locum tenens. Somewhat surprisingly, a recent survey by physician staffing firm LocumTenens.com revealed that 16 percent of the respondents who hire locum tenens physicians do not bill for their services, because they do not know how or because the exercise seems too complicated. Medicare and most commercial payers allow payment for the use of locum tenens providers, however, and it is worth knowing the rules.
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Do You Know Where Your Anesthesia Practice’s Patient Records Are Tonight?
June 30, 2014
Keeping patient information confidential has become a major challenge since we all began storing so much of it in electronic form. Computers, tablets and smart phones containing unsecured electronic Protected Health Information (ePHI) go missing and are reported in the press on at least a weekly basis.
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Value in Anesthesia and Price Transparency
June 23, 2014
Two recent Alerts focused on the growing movement toward transparency of medical prices. (How Much Did Medicare Pay Each of 32,641 Anesthesiologists in 2012?, April 21, 2014 and Private Payer Information on Anesthesia and Other Services: Claims Data to Be Available Next Year, May 19, 2014.) The first of these discussed CMS’ April 9th release of a massive database with information on the approximately $77 billion that Medicare paid out to more than 800,000 physicians and other non-hospital providers in 2012. The May Alert examined three large insurers’ announcement that they were establishing an online database of paid claims that would provide public information about the price and quality of healthcare services.
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Anesthesiologists as Operating Room Directors: The Advantages
June 9, 2014
For the first time, we are using an issue of the Alert to reproduce a third-party article in full. Dr. Steven Boggs’s thoughts on “anesthesiologists as operating room directors” add such a lot to the concept of “anesthesiologists as medical directors” that they deserve to be read unabridged, undiluted and unencumbered by extraneous ideas. We are grateful to Dr. Boggs and to PhySynergy for granting us permission to publish this article, which appeared on PhySynergy’s AnesthesiaReviews Blog on March 10, 2014.
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Reporting PQRS Measures: Anesthesiology’s Own Quality Clinical Data Registry (QCDR)
June 16, 2014
Until now, claims-based reporting has been the only Physician Quality Reporting System (PQRS) option for most anesthesiologists. While the method of reporting, inserting the five-digit PQRS codes for the PQRS measures on one’s Medicare claims, has been easy enough, finding enough quality measures that apply to anesthesia practices has been more of a challenge.
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Meaningful Use Stage 2 Reprieve Helps Anesthesia Practices
June 2, 2014
Under CMS’ current Medicare and Medicaid electronic health record (EHR) incentive program regulations, eligible professionals (EPs) must use 2014 edition certified EHR technology (CEHRT) to demonstrate meaningful use for either Stage 1 or Stage 2 in 2014. Many EHR vendors have not yet met the criteria to obtain certification for the 2014 edition, or they have too large a backlog of installations to comply with the timeline, however. On May 20th, CMS issued a proposed rule that would push back the deadlines for implementation of 2014 edition systems for the Medicare program.
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Anesthesia Patient Satisfaction Surveys
May 27, 2014
Are there any anesthesia or pain medicine practices that have not yet implemented a patient satisfaction survey?
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Private Payer Information on Anesthesia and Other Services: Claims Data to Be Available Next Year
May 19, 2014
Aetna, Humana and UnitedHealthcare have announced plans to establish an online database of paid claims that will give consumers, employers and federal and state governments information about the price and quality of healthcare services
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Meaningful Use of Electronic Health Records by Anesthesiologists and Pain Physicians – 2014
May 12, 2014
Anesthesiologists are automatically exempt from the meaningful use requirement and from penalties in 2015 as long as they have registered in the Provider, Enrollment, Chain and Ownership System (PECOS) using anesthesiology’s specialty designation (05). Any anesthesiologist who is at all unsure should check that he or she has created an account in PECOS and that the information is correct—also before July 1, 2014. Hospital-based anesthesiologists are not merely excepted; they are excluded from the EHR incentive program altogether and can neither earn the bonus nor be subjected to penalties. “Hospital-based” is defined narrowly under the program’s rules, however: the EP must provide 90 percent or more of his or her covered services in a hospital inpatient or emergency room setting. Most anesthesiologists do not provide anything like 90 percent of their covered services in the hospital inpatient or ER setting unless their practice is limited to cardiac, transplant or critical care work.
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The Distracted Anesthesiologist
May 5, 2014
When is it acceptable for anesthesiologists, or nurse anesthetists or anesthesiologist assistants, to use their smart phones in the OR?
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Anesthesiologist Compensation Surveys
April 28, 2014
Anesthesiologists, once the third most highly-paid specialists, have dropped to sixth place in Medscape’s latest survey of physician compensation. The 2014 report, based on 2013 data, shows an average income from patient care activities of $338,000 for anesthesiologists, compared to $413,000 for orthopedic surgeons, who are at the top of the list.
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How Much Did Medicare Pay Each of 32,641 Anesthesiologists in 2012?
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.
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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.
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Healthcare Industry Trends for Anesthesiologists to Ponder
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.
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ICD-10 Diagnosis Coding and Anesthesiologists’ New Documentation Responsibilities
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.
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How Does the ACA “Grace Period” Affect Anesthesia Practices?
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.
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Beyond the Anesthesia Component of Bundled Payments for Surgery
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).
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Hospital-Physician Integration, Antitrust and Anesthesia Groups
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.
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What Does Medicare’s Physician Compare Website Say about Anesthesiologists, CRNAs and AAs?
March 3, 2014
Have you checked how your information appears on Medicare’s Physician Compare website? Is it accurate?
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Are ACOs Succeeding? An Update for Anesthesiologists
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.
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Anesthesia Services are in the OIG’s Annual Work Plan Again
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.
