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Tony Mira, Chairman and Chief Executive Officer of MiraMed

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Tony Mira founded MiraMed Global Services, Inc. in 2005 and serves as its Chairman and Chief Executive Officer. Mr. Mira also Co-Founded MiraMed's subsidiary Anesthesia Business Consultants, LLC in March 2001 and serves as its Chairman and Chief Executive Officer. By bringing these companies together under the MiraMed moniker, he has formed one of the largest healthcare Business Process Outsourcing (BPO) companies in the United States.

HR Essentials for Anesthesia Groups: Keys to Finding and Keeping the Best

In the current competitive environment, long-term relationships between anesthesia groups and healthcare organizations are no longer the given they once were, and success for anesthesia practices hinges on their resilience and adaptability as market conditions and hospital requirements change. A cohesive, united group is more likely to weather the ...
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Transitioning to an Anesthesia EMR? Think System Modification First

​Although the majority of hospital-based ABC clients have implemented an electronic medical record, or plan to implement one in the near future, many of our ambulatory surgery center clients have been slower to move from paper to a digital platform. However, the transition is an inevitability for all practices. We review the essentials of a success...
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Keep Reporting MIPS Anesthesia Quality Data in 2019: Here’s Why

As noted in our December 17, 2018 eAlert, the budget neutrality required by MACRA for the Merit-Based Incentive Payment System (MIPS)—coupled with the high performance by the vast majority of participating anesthesia and chronic pain management groups in the Quality Payment Program (QPP)—means that providers within the specialty are unlikely to ear...
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Harnessing Technology to Improve Anesthesia Quality: Part 2

Despite some potential pitfalls, health information technology can be used to improve anesthesia quality in a multitude of ways. In a follow-up to last week's eAlert, we provide additional examples from a presentation on the use of HIT in anesthesia at PRACTICE MANAGEMENT™ 2019.In last week's eAlert, we discussed some of the ways that health inform...
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Harnessing Technology to Improve Anesthesia Quality: Stories from PRACTICE MANAGEMENT™ 2019

​Though it is far from perfect, health information technology can be used in anesthesia to improve quality in a multitude of ways. We summarize some of the examples presented in a presentation by Mark A. Deshur, MD, MBA, of NorthShore University Health System at PRACTICE MANAGEMENT™ 2019.Anesthesia providers typically think of anesthesia informatio...
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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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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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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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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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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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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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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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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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Anesthesia Roads Less Traveled: Paths to Executive Leadership Positions

Among the offerings at ANESTHESIOLOGY® 2018 was a panel discussion by three anesthesiologists who have made the successful transition to executive leadership roles in healthcare administration, industry and public policy. We highlight selected comments from the panelists and ASA resources for members interested in pursuing various kinds of leadersh...
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Network Adequacy and Access to Anesthesia Care

SummaryThe Texas Department of Insurance recently fined insurer Humana $700,000 for failing to contract with a sufficient number of anesthesiologists to ensure that patients had the ability to receive their anesthesia care from in-network providers. Some patients had received "surprise" medical bills as a result of the insurer's failure to comply w...
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