The Value of the Anesthesia Database
Summary: Anesthesia retains a unique tool that has the potential to positively reshape efficiency, financial viability and work flow. The problem is that this tool is so often poorly wielded by both the group and the facility.
Historically, revenue cycle management companies have developed their software to navigate the intricacies and exigencies of billing. The idea was to ensure that claims could be coded and calculated correctly. The software included all the claim formatting requirements for each distinct plan. One of the primary challenges of today's anesthesia billing is that the way charges are calculated does not always conform to the way payers calculate payment. Billing software used to serve an important editing function to ensure prompt and accurate claim submission and payment verification. Management reporting tended to focus on the financial and provide industry standard views and metrics so that clients could monitor collections, evaluate revenue cycle performance and track key trends, such as evolution of payer mix.
A Superior System
As is true of so many aspects of today's healthcare, it has become increasingly complex. It now takes more than consistent cash flow to effectively manage an anesthesia practice. Successful managers must constantly monitor and manage all the economic variables, including staffing, provider productivity, the profitability of each line of business and a number of quality metrics. The good news is that, as a rule, the anesthesia billing system has more and better data about what actually happens in the operating room and delivery suites than any other source. The anesthesia database already has the unique potential to provide all necessary management tools.
Consider the significance of the fact that the anesthesia billing system contains all the pertinent details of every surgery or delivery for which anesthesia was provided. These details reflect not only what the surgery was and how long the case took, but also when it occurred, the patient's physical status and any underlying medical conditions. When a surgeon books a surgical procedure for two hours, the anesthesia team can easily verify if that is a reasonable request or an aspirational request. Although anesthesia is often captive to the practices of the O.R. scheduling team, imagine how operating room productivity could be improved if anesthesia played a more integral role. There is no more valuable source information to perform quality review and morbidity and mortality assessments.
Utilization Issues
When it comes to operating room utilization, it often seems as though the anesthesia team is on a different page than the hospital is on. When an anesthesia practice tracks activity by anesthetizing location it has a true measure of productivity. Hospitals may have their own way of tracking O.R. utilization, but none can be as accurate and useful as measuring actual hours of billable anesthesia time, billable ASA units or actual anesthesia profitability per anesthetizing location. The anesthesia database allows for the identification of underused locations and the impact of flip rooms. It is true that many anesthesia groups find it difficult to effect critical utilization changes but this does not need to be the case. There have been some useful examples of practices that pro-actively share their data with administration to encourage a dialogue about ways to enhance productivity. Let us not forget that every unproductive venue ultimately costs the facility on two levels: in terms of the staff it must employ and in terms of the financial subsidy that will be paid to anesthesia.
A Time of Transition
Today's reality is that most practices are in transition. They are either growing, shrinking or migrating to an employment model. Isn't it interesting that the one thing that has made anesthesia providers so clinically effective—the availability of timely and accurate clinical measures of all key body systems—is often not applied to the management of the anesthesia practice itself? This myopia is both detrimental and unnecessary. Today's market reality gives new urgency to the concept of thinking outside the box. Successful managers must now monitor all the factors that potentially impact the success or failure of the practice.
Mohandas Gandhi used to say that actions express priorities. In many ways, the priorities of anesthesia providers have had to evolve. Individual provider success no longer means anything if the practice as a whole cannot be successful. As a quintessential service specialty, anesthesia must learn and apply the lessons of all other customer service organizations. It is not the occasional disagreement that undermines relationships with the facility so much as the inability to acknowledge weakness and shortcomings, while looking for ways to improve the customer's experience.
Our readers should remember that we have developed an industry leading tool, Anesthesia Touch™. This advanced electronic technology provides a flexible data management process with the added advantage of a full-featured anesthesia information management system. It gives anesthesia providers the power to manage their billing and data, as well as their quality reporting. If you would like to explore ways to enhance your business decision-making, such as integrating Anesthesia Touch, feel free to contact your account executive or reach out to us at info@anesthesiallc.com.