There has been substantial growth in the number of ambulatory surgery centers across the United States. With the advancement in technology for non-invasive procedures, and shorter-acting anesthetics, more patients are being seen in the freestanding surgery facility (FSF). However, the trend in patient co-morbidities, i.e., obesity, diabetes, cardiac, and respiratory diseases has also risen, increasing the anesthetic risk even though low risk procedures are performed. The most common malpractice claims have been associated with diagnostic procedures performed in ambulatory surgery centers under monitored anesthesia care (MAC) with patient co-morbidities as contributing factors. The morbidity and mortality of ambulatory surgery patients has led to an increased concern for patient safety in freestanding facilities. Of particular concern is sedation, specifically in gastroenterology (GI) centers. Yet, the Journal of the American Medical Association (JAMA) recently reported that two-thirds of the anesthesia procedures provided during colonoscopies and endoscopies (EGDs) were on “low-risk patients;” suggesting...
Anesthesiologists who satisfy the requirements for participation in the specialty Maintenance of Certification (MOCA) program are eligible for an additional 0.5% PQRS bonus for the years 2013 and 2014.Under the PQRS program, board-certified physicians are eligible for the additional MOC:PQRS incentive payment if they (1) satisfactorily report quality measures for the 12-month reporting period, qualifying for the basic PQRS bonus and (2) participate in the applicable MOC program “more frequently than is required to qualify for or maintain board certification status” and successfully complete a qualified MOC program practice assessment for the 12-month period.The American Board of Anesthesiology (ABA) has recently qualified as a MOC:PQRS entity. As a qualified entity, the ABA defines what constitutes “more frequent participation” than is required for board certification. Last week, the ABA notified its diplomates by e-mail of the availability of the MOCA and provided them with step-by-step instructions.Step-By-Step InstructionsTime limited and non-time limited certificates. ...
“The Competition”
These days I hear that term from more and more anesthesia group leaders, and I’m sure that you’re thinking about it more than you’d like.
From the Latin root competitionem, its meaning originated in the sense of rivalry, of a contest for something. Since at least the 1790s, it’s been used to describe rivalry in the marketplace.
Ask yourself what “the competition” means to you. What comes to mind?
In working with anesthesia group leaders across the country, my regular experience is that they envision the competition as another anesthesia group, whether from across the county or across the country. These days, the image that often first comes to mind is that of the predatory staffing-service model.
I certainly can’t fault these group leaders because, especially these days, there is tremendous competitive pressure from outside entities coveting your facility contracts.
So, for most group leaders protecting their practice from... 
The American Hospital Association (AHA) has just released a report that describes the strategies that will help its nearly 5,000 member hospitals succeed in the value-based healthcare environment. This report, Metrics for the Second Curve of Health Care, will be of interest to all anesthesiologists who want to understand and meet their hospitals’ needs—and that should include all anesthesiologists who work in a hospital. Whether you have held the anesthesia franchise at your institution for decades with no competition, or whether you are seeking ways to improve or even launch a relationship with a hospital, you will benefit from knowing administration’s goals.The title of the new AHA report comes from futurist Ian Morrison’s “first curve,” the current volume-based healthcare payment environment, and “second curve,” the coming value-based market. It is a sequel to the AHA’s 2011 synthesis of interviews with hospital and health system leaders entitled Hospitals and Care Systems of the Future. ... 
The creation of the Medicare/Medicaid Electronic Health Record (EHR) Incentive Program (commonly known as the “Meaningful Use Program”) gave physicians and hospitals a strong incentive to integrate EHRs into their practices. (For more information regarding Meaningful Use, see “Proposed Meaningful Use Stage 2—What it Means to the Anesthesia and Pain Communities” published in the Spring 2012 issue of the Communiqué.) As part of their EHR system, many anesthesiologists have started using mobile devices such as laptops, tablets and smartphones. If used properly, these devices allow access to patients’ EHRs from anywhere that a WiFi connection (or cell phone signal) is available. This often results in quicker responses to questions from patients, families, and other providers. While the use of mobile technology has benefits, anesthesiologists choosing to utilize this technology must pay special attention to making sure they do so in a manner that conforms to their group’s or facility’s security policy...