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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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On Diversion, Depression and Emergency Department Visits: An Update on Opioids for Pain Specialists and Anesthesia Providers

SUMMARY A data analysis offers eye-opening findings about opioid prescriptions and the most common mental health disorders. Nurse anesthetists find benefits in a beta blocker as an opioid-sparing technique for shoulder surgery patients. Two major pharmacy groups zero in on the waste stream as a source of drug diversion. We present these and several...
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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 Releases MACRA/QPP Year 2 Proposal: Highlights for Anesthesiologists and Nurse Anesthetists

SUMMARY Proposed guidelines for the second year of the Quality Payment Program (performance year 2018, payment year 2020) would exempt many (but not all) anesthesia providers from the requirement to participate by increasing the low-volume thresholds for Medicare Part B from $30,000 in allowed charges or 100 beneficiaries to $90,000 or 200. We...
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Effective Governance: Who Decides What?

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TN Over the years, you may have heard the old saying that "Nothing happens until someone sells something." With regard to anesthesia groups, we have found that "Nothing (good) happens until the group has effective governance."Without effective governance: The group lacks the ab...
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What Are Comparative Billing Reports and Why Should Anesthesia Groups Care About Them?

SUMMARY CMS has sent approximately 8,000 anesthesia practitioners a CBR on anesthesia for lower endoscopy. These data-driven reports show clinicians how their billing patterns compare with those of their peers at the state and national levels. We request that our clients send ABC a copy of this CBR or any other CBR that they receive so that we can ...
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Why Your Compliance Efforts May Be Worthless

It'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 turns what many think about federal healthcare law compliance on its head.It signals that man...
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A Medicaid Myth: News for Anesthesia Practitioners

​Summary A recent survey by the Commonwealth Fund debunks the commonly-held belief that Medicaid offers an inferior level of care. According to the survey, Medicaid enrollees report better care experiences than the uninsured and similar experiences as the privately insured; receive preventive services at higher rates than the uninsured; and ha...
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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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Anesthesia Practitioners: CMS Prepares for New Physician Compare Star-Based Rating System

SUMMARY A new five-star quality rating system for clinicians and group practices will become part of the Physician Compare website in late 2017. The purpose of the system is to help patients and others make more informed choices. The ratings will be based on data from the Physician Quality Reporting System in the first year, and, in later years, dr...
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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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AI and Machine Learning in Healthcare and Anesthesia: Where Are We Going?

​Summary The growth of big data, advances in software and hardware, and the development of cloud-based business models are fueling an explosion in the use of machine learning (artificial intelligence), particularly in healthcare. All clinicians, including anesthesiologists and nurse anesthetists, are likely to find themselves incorporating ML ...
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An AHCA (H.R. 1628) Update for Anesthesia Groups

The latest version of the House bill to repeal and replace the Affordable Care Act, passed in early May, would reduce the federal deficit by $119 billion and result in 23 million additional uninsured Americans by 2026 compared with current law, according to a new report from the Congressional Budget Office and the Joint Committee on Taxation. We h...
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The Perioperative Surgical Home: Preoperative Risk Stratification, Optimization and Value

Payers, patients and partners are demanding better outcomes, and evolving healthcare paradigms are begging for greater anesthesia engagement. If you have been following this series, then you already know that the perioperative surgical home (PSH) is the answer to the call and the future of our specialty. What you may not know is how easy it can be ...
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