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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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Why and How You Must Prepare Your Anesthesia Group for the Future

Ah. The future. What's it have in store for your anesthesia practice and what must you do to prepare your group for it? Some think that the future will be a continuation of the present, or, even worse, a return to an idealized past. They're both wrong.But the present does hold clues as to what the future will bring, and based on them, I'll make som...
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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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Setting Your Strategic Goals in Motion: A How-To Guide for Anesthesia Groups

I find the great thing in this world is not so much where we stand, as in what direction we are moving: to reach the port of heaven, we must sail sometimes with the wind and sometimes against it—but we must sail, and not drift, nor lie at anchor. — Oliver Wendell HolmesIn earlier Communiqué articles ("Hope is Not a Strategy: A Primer for Anesthesia...
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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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Hospital Co-Management Arrangements: Basics for Anesthesiologists

Anesthesia groups continue to be presented with opportunities to participate in hospital co-management arrangements. These arrangements are one way that hospitals and physicians can align in order to improve the quality and efficiency of care provided through one or more hospital service lines.By achieving such objectives, participating hospitals a...
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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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A Self-Diagnostic for High-Performing Anesthesia Group Leaders

Although the editor, bless her heart, steadfastly refused to let me have a sneak, pre-publication peek at the other articles that appear alongside this one, my educated guess is that each of them purports to give you answers.I know that's why you usually read Communiqué. In fact, nearly every one of the hundreds of other articles that I've written ...
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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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Adding Value for Special Circumstances: Field Avoidance and Special Positioning

Kelly D. Dennis, MBA, ACS-AN, CANPC, CHCA, CPC, CPC-I Perfect Office Solutions, Inc., Leesburg, FLIn coding and billing for anesthesia services, it often seems that just when you think you understand the rules, something changes.One area of anesthesia billing that consistently confuses practices and coding professionals is the ability to add value ...
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Anesthesia Practitioners, Pain Specialists and the New Joint Commission Ambulatory Care Pain Requirements

The new and revised Joint Commission standards for pain assessment and management for ambulatory care, critical access hospitals and office-based surgeries will go into effect in January 2019. Anesthesia groups should review their departmental policies and procedures and modify them as needed to ensure compliance.In June of this year, The Joint Com...
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Strength Means Service, Not Scale, in Today’s Anesthesia Market

A recent analysis of the financial information of 104 leading health systems (more than 2,200 hospitals) found that size and profitability do not necessarily go hand in hand. The report, by Navigant, throws into question the common wisdom that scale is required to deliver the effectiveness, cost efficiency, care coordination, physician recruitment ...
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Anesthesia for Endoscopy: Economics 101

​Following dramatic growth in the provision of—and reliable reimbursement for—anesthesia services by an anesthesiologist or nurse anesthetist for endoscopic procedures, we are seeing isolated payer policy changes intended to limit utilization. We predict similar changes from other key payers. We advise anesthesia practices that are expanding their ...
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What is the Future of Private Anesthesia Practice?

Jody Locke, MA, Vice President of Anesthesia and Pain Practice Management Services Anesthesia Business Consultants, LLC, Jackson, MIMany anesthesia providers look at the changes taking place in the specialty and shake their heads. Today's practices bear little or no resemblance to practices of 10 or 20 years ago. Who could have envisioned groups wi...
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Insights for Anesthesia Practitioners on Wrong-Site Nerve Blocks

Though rare, wrong-site nerve blocks are much more common than wrong-site surgery, according to a large incidence study. Two organizations, the Pennsylvania Society of Anesthesiologists and the Pennsylvania Patient Safety Authority, joined forces to develop a consensus-based, peer-driven protocol that incorporates practices with unique relevance fo...
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A Refresher for Anesthesia Practices on Business Associate Agreements: Are Your Contracts in Order?

Covered entities, including anesthesia practices, are required under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to execute a contract with business associates to safeguard the privacy and security of protected health information (PHI). As the holder of the PHI, anesthesia groups should make sure they understand and carr...
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What Is Agile and What Can It Do for Anesthesia?

Agile improvement methods based on an iterative project management approach first used in the software industry can be applied to a variety of problems in healthcare, including those related to anesthesia care. We review key characteristics of the Agile approach and offer examples from the scientific literature.Does the word "agile" mean anything t...
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Current Data on Anesthesiologist Compensation

We summarize findings on anesthesiologist compensation from the Medscape Anesthesiologist Compensation Report 2018. The survey reports total annual compensation for anesthesiologists of an average of $386,000, a six percent increase from the 2017 report. A multitude of factors are used to determine compensation, and actual compensation figures amon...
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