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Anesthesia Drug Prices and Shortages on the Rise: AHA Study

Soaring drug prices and persistent drug shortages during 2015-2017, including those for important anesthesia drugs, led one-fourth of United States hospitals to reduce staff to cope with the financial pressure, according to a study commissioned by the American Hospital Association (AHA), the Federation of American Hospitals (FAH) and the American S...
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An Update on the ‘Company Model’ and Other Anesthesia Kickback Schemes

Kickbacks in healthcare are rarely (but not never) as blatant as an envelope of cash passed under the table. But they do exist in many forms and settings.When asked why he robbed banks, the notorious criminal Willie Sutton reputedly responded, "Because that's where the money is." Referring physicians, quite often but not always the owners of facili...
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Anesthesia Time and Field Avoidance: Changes to the 2019 RVG

Summary: The 2019 Relative Value Guide contains changes regarding field avoidance and anesthesia time that anesthesia practitioners should be aware of. In brief, the new guidance regarding field avoidance emphasizes limited airway access, and the new guidance regarding anesthesia time incorporates the concept of discontinuous time. ABC clients with...
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Motivating Your Group to Deliver Value: Incentives That Work

There is a lot of talk in anesthesia and all of medicine and healthcare today about providing value.These discussions primarily focus on providing value to important constituents (such as a hospital) so that the anesthesia group can continue to work with the institution. But anesthesia groups work with a variety of stakeholders, and each of these s...
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Adding Chronic Pain Management to Anesthesia Services? Think Metrics, Market and Incentives

Summary: Anesthesia practices interested in adding chronic pain management to their services should think carefully about the keys to long-term viability: clinicians who are fellowship trained; a market with a sufficient number of patients with conditions that would benefit from interventional care; in a crowded market, unique clinical offerings th...
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The 2019 MACRA/MIPS QCDR Quality Category: What Anesthesia and Pain Management Groups Need to Know

Summary: The budget neutrality required by MACRA and the high performance by anesthesia and pain management groups in the Quality Payment Program so far means that providers within the specialty are unlikely to earn significant bonuses by participating in MIPS in 2019. However, compelling reasons to continue reporting remain: 1) insurance carr...
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Will You Join Us In Helping the Homeless This Holiday Season?

Working Together to Raise Money to Provide 1,000 Coats!The MiraMed Family of Companies has created the MiraMed Circle of Warmth Campaign and partnered with an exceptional project called the Empowerment Plan, a Detroit-based nonprofit organization focused on permanently elevating families from the generational cycle of homelessness. The project hire...
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An Update on Evaluation and Management Coding for Anesthesia Providers

Summary: Although anesthesiologists do not bill for Evaluation and Management visits frequently, providers should be aware of the situations in which failure to use these codes can lead to lost revenue. We review these situations and other E&M coding issues of interest to anesthesia providers, including optional changes in E&M documentation...
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Independent Anesthesia Group Practice: A Short Manifesto

"Most people will choose unhappiness over uncertainty. -Tim FerrisAnesthesia groups are facing great challenges in today's environment. I am sure you are aware of these various challenges so I won't belabor them.The question is: What do we do now?Some groups are throwing in the towel and selling out. It seems as though every few weeks another indep...
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How Will Price Transparency Impact Anesthesia Practices?

Summary: The movement toward increased healthcare price transparency is likely here to stay. Anesthesia groups need to be aware that patients are going to have increasing access to information about the costs of procedures, and that this information could conceivably influence activity levels and patterns at their facilities.In a previous eAlert, w...
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What is the Future of Private Anesthesia Practice?

Many anesthesia providers look at the changes taking place in the specialty and shake their heads. Today's practices bear little or no resemblance to practices of 10 or 20 years ago. Who could have envisioned groups with hundreds or even thousands of providers working for one entity?That unforeseeable future is today's reality. And what do we make ...
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Digital Strategy and Social Media Essentials for Anesthesiologists: 'Lead or Be Left Behind'

Summary: Social media can be a powerful tool to help you reach your professional goals, whatever they may be. We provide an overview of a presentation by Marjorie Stiegler, MD, on digital strategy for physicians at ANESTHESIOLOGY® 2018.In 2013, 350 people on Twitter generated 220,000 "impressions" related to the ASA scientific meeting using the eve...
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Lessons Learned: Five Tips for Buying or Selling a Practice

Kathryn Hickner, Esq. Kohrman, Jackson & Krantz LLP, Cleveland, OH If you are anticipating buying or selling a practice during the coming months, you are not alone. The healthcare industry is experiencing a wave of integration. In fact, it has been occurring for several years. Many transactional healthcare attorneys have negotiated and closed d...
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2019 Physician Fee Schedule: Highlights for Anesthesia Providers

​Summary: The national anesthesia conversion factor for the 2019 Physician Fee Schedule final rule increased minimally to $22.27 from $22.19 in 2018. We review highlights of the 2019 rule with relevance for anesthesia providers, including changes to the Quality Payment Program for payment year 2021. Significant changes in documentation requirements...
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Why and How You Must Prepare Your Anesthesia Group for the Future

Ah. The future. What's it have in store for your anesthesia practice and what must you do to prepare your group for it? Some think that the future will be a continuation of the present, or, even worse, a return to an idealized past. They're both wrong.But the present does hold clues as to what the future will bring, and based on them, I'll make som...
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The 2019 OPPS/ASC Payment Rule: Implications for Anesthesia Groups

Summary: The 2019 OPPS/ASC final rule adds 12 cardiac catheterization procedures and five additional cardiology procedures to the ASC list of covered procedures. As a result, many anesthesia groups will see a change in the mix of procedures at their ASCs starting in 2019 and should begin planning accordingly.The Centers for Medicare and Medicaid S...
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Becoming a Cheetah and Other Survival Tactics

In her blog, A Penned Point, early this year, Karen Sibert, MD, president of the California Society of Anesthesiologists, asked her fellow specialists to take some time during Physician Anesthesiologists Week to celebrate the specialty's accomplishments, but also to reflect on the state of the profession today, the anesthesiologist's place in the c...
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Anesthesia Groups: Build a Healthier Environment to Combat Burnout

The current framework for addressing burnout, including burnout among physicians and other healthcare professionals, tends to be one that attempts to 'fix' the individual, but burnout is really a warning sign to the organization that it needs to make improvements in the social and psychological environment. We offer highlights of a presentation by ...
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Setting Your Strategic Goals in Motion: A How-To Guide for Anesthesia Groups

I find the great thing in this world is not so much where we stand, as in what direction we are moving: to reach the port of heaven, we must sail sometimes with the wind and sometimes against it—but we must sail, and not drift, nor lie at anchor. — Oliver Wendell HolmesIn earlier Communiqué articles ("Hope is Not a Strategy: A Primer for Anesthesia...
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Telemedicine in Anesthesia: Perioperative Medicine’s Newest Disruptor?

​Summary: The use of telemedicine to streamline care, reduce costs without compromising quality, and enhance patient satisfaction and engagement among a highly technology-connected population of healthcare consumers shows promise in the delivery of perioperative services. We offer highlights of a presentation on telemedicine in anesthesia at ANESTH...
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