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The Anesthesia Insider

Inside information for anesthesiologists and Certified Registered Nurse Anesthetists (CRNAs) on the most current best practices during changing times.

Anesthesia Practitioners: Expand Your Safety Role to Reduce OR Greenhouse Gas Emissions

SUMMARY The public health impact of the environmental pollution created by the healthcare sector is commensurate with the scale of hospital deaths due to preventable medical errors, recent research shows. The operating room is an environmental hot spot and major generator of waste, and the greenhouse warming potential of inhaled anesthetics is...
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Building Professional Resilience: Strategies For Anesthesia Practitioners

Brianna Barker Caza, PhD Associate Professor, Asper School of Business, University of Manitoba, Winnipeg, Manitoba, Canada M. Teresa Cardador, PhD, MPH Assistant Professor, School of Labor and Employment Relations, University of Illinois at Urbana-Champaign, Champaign, IL It is becoming all too common for physicians to report feeling overwhelmed by...
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News for Anesthesia Groups: ACA Repeal, ADRs, Opioid Prescribing and Medicare ID Cards

SUMMARY This eAlert offers news briefs of interest to anesthesia practices on: the Republicans' latest attempt to repeal and replace the Affordable Care Act; the new Medicare ID number initiative and what practices should be doing now to prepare; a primer on additional documentation requests (ADRs) and why a timely response is essential; and c...
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Anesthesiologists in the ICU: Economics and Other Considerations

Very few private anesthesia practices provide services in their hospitals' intensive care units (ICUs). The lack of enthusiasm for staffing the ICU relates directly to a perception that ICU coverage is not as profitable as operating room (OR) coverage. The entire Anesthesia Business Consultants client database only yields a few examples of private ...
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CMS Emergency Waivers Help Hospitals and Anesthesia Providers Care for Hurricane-Affected Patients

SUMMARY The Centers for Medicare and Medicaid Services (CMS) has issued several waivers and modifications of certain federal healthcare program requirements to enable beneficiaries impacted by Hurricanes Irma and Harvey to receive emergency and other care and to allow providers to be reimbursed for their services. It behooves all anesthesia ca...
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Why Your Compliance Efforts May Be Worthless

Mark F. Weiss, JD The Mark F. Weiss Law Firm, Dallas, TX, Los Angeles and Santa Barbara, CAIt's a riddle almost as inscrutable as that of the Sphinx: How can a physician or pharmacist or facility owner be convicted of a federal crime for violating a state law? The answer is, unfortunately, quite simple, quite questionable and quite dangerous. It tu...
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A Compliance Reminder for Anesthesia Groups: Check Monthly OIG Work Plan Updates

​SUMMARY The Office of Inspector General has begun issuing monthly rather than yearly or biannual updates on its Work Plan. Anesthesia and pain groups should become familiar with the new format on OIG's website and subscribe to the agency's Work Plan updates to stay informed. The 2017 Work Plan includes two anesthesia-related items: non-covere...
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Predictions for Healthcare in a Trump Era

Healthcare has been the talking point for generations, but its presence has been even more pronounced since President Obama's election in 2008. Such discussions have revolved around passing comprehensive healthcare reform, passing the Affordable Care Act (ACA or "Obamacare"), repealing the ACA and replacing it with the American Health Care Act of 2...
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Anesthesia Services and ‘Surprise’ Billing Laws: How Are Practices Managing?

SUMMARY Comprehensive laws restricting balance billing have been passed in several states, and many more states have introduced legislation. In general, anesthesia groups have adapted by aligning with their facilities' contracting strategies and in-network profiles; however, strategies for anesthesia practices remain diverse and market-specifi...
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Your Hospital Issues an RFP for Anesthesia Services: Now What?

Robert Johnson, MBAPrincipal, Enhance Healthcare Consulting, Aventura, FLRobert Stiefel, MDCo-Founder and Principal, Enhance Healthcare Consulting, Aventura, FLAs a national anesthesia consulting firm, we are seeing hospitals and healthcare systems change or attempt to change their incumbent anesthesia groups with increasing frequency. A recent sur...
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The ACA’s Impact on Anesthesia Practices: What We’ve Learned

SUMMARY A review of data in selected markets indicates that, while the impact of the ACA varies significantly in different parts of the country, anesthesia practices have, on the whole, fared well with health reform. Despite the slow but steady increase in Medicare patients, the net yield per unit continued to rise for most ABC clients from 2012 to...
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Hospital CEO Turnover: What You Must Know and Do to Protect Your Anesthesia Group

You and I are sitting in the hospital boardroom directly across from the hospital's CEO.We're negotiating the last few points on the renewal of your group's exclusive contract.Perhaps we're pushing for something minor in the scope of things, but it's still important to your group. For example, it could be for continuing the funding of the surgeon s...
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Anesthesia Groups, Take Note: Data Breach Website Helps Providers Research and Report

SUMMARY The Department of Health and Human Services' data breach portal no longer lists data breaches indefinitely, but rather, archives incidents once they have been resolved. The agency also has introduced a revised Health Breach Reporting Tool that connects providers and patients with extensive resources and assistance with reporting and prevent...
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Where Do We Go From Here? Choosing the Right Path in Turbulent Times

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TNThe environment continues to be a challenging one for anesthesia groups. Health systems are combining, stipends are under pressure and payment system changes loom. And there is always someone knocking at your hospital CEO's door saying they can do it better, faster and cheape...
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Anesthesiologist Assistants as Physician Extenders: An Option Whose Time Has Come?

SUMMARY Anesthesiologist assistants (AAs) are highly trained professionals who work solely in the anesthesia care team environment under the supervision of a physician anesthesiologist. With the looming anesthesiologist shortage due to an aging population and increased demand for surgical services, the addition of AAs to the care team might be...
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Are You Prepared for a Ransomware Attack?

Neda M. Ryan, Esq. Compliance Counsel, Anesthesia Business Consultants, LLC, Jackson, MIImagine seeing the following message flash onto your computer screen: "Many of your documents, photos, videos, databases and other files are no longer accessible because they have been encrypted." What would you do?That is the message computer users in more than...
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The Future of Payment for Ultrasonic Guidance: Predictions for Anesthesia Providers

SUMMARY During the past five years, the code for fluoroscopy guidance in the management of chronic pain (77003) has been bundled into all of the most common chronic pain modalities, such as paravertebral facet joint injections and transforaminal injections. The same thing seems to be happening with the use of ultrasonic guidance (USG) in the p...
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Strategy and Adaptability in a Competitive Market: Lessons from the Nation’s Largest Anesthesia Organizations

Howard Greenfield, MD Co-Founder and Principal, Enhance Healthcare Consulting, Aventura, FLJody Locke, MA Vice President of Anesthesia and Pain Practice Management Services Anesthesia Business Consultants, LLC, Jackson, MIAs of April 1, 2017, eight entities employed more than 22 percent of all anesthesia providers in the United States. The size and...
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EMRs in Anesthesia: Smart Tips for a Smoother Transition

SUMMARY Moving from a paper-based anesthesia record to an anesthesia information management system (AIMS) or from one AIMS to another is not a simple task, but anesthesia care providers can ease the transition by becoming involved early in the process, working closely with their billing vendor to minimize the implementation's negative impact on acc...
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Building a Solid and Secure Future in Anesthesia

One look at a graph showing completed acquisitions of anesthesiology and pain practices over the past several years reveals an upward slope and a clear illustration of a marked trend within the specialty. Acquisitions have grown steadily, from three in 2009 to 37 in 2016. According to one source, anesthesia and pain practice acquisitions increased ...
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