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The Evolving Relationships between Anesthesiologists and Their Hospitals and ASCs

By the time this issue of The Communiqué is in your hands, 2015 will be a fading memory and 2016 will have begun to take shape.

One important voice sounding a warning or at least a heads-up about what is coming is that of Mark Weiss, Esq. The title of Mr. Weiss’s article— Impending Death of Hospitals: Will Your Anesthesia Practice Survive?—which is also the title of his forthcoming book—is intentionally provocative. He lays out several of the major threats confronting hospitals, starting with health system growth, through mergers and acquisitions, acquisition of physician practices and investments in integrated delivery networks. Others have predicted that the Federal Trade Commission will place a damper on hospital merger activity in 2016, but the quest for greater scale and scope is going to continue. Anesthesiologists may want to consider the wisdom of relying on the ongoing health of just one or two hospitals. This is especially true in light of the ability of physician-owned facilities, notably ambulatory surgery centers, and new technologies (think telemedicine) to disrupt hospitals’ traditional business. Mr. Weiss concludes in no uncertain terms that anesthesiologists who are not yet deeply engaged with freestanding facility care should turn in that direction.

Of course, with more than 5,600 licensed hospitals in the U.S., the need and opportunity for anesthesiologists in hospitals is not going to dissipate completely in the near future. In the Fall 2015 issue of The Communiqué, Rick Bushnell, MD, MBA explained why forming a perioperative surgical home (PSH) with the active support of the hospital was right for his group. He brings us up-to-date on the process of agreeing upon goals, priorities and resources that has led to the formation of a true partnership in his new article The Perioperative Surgical Home: Our Partnership with the C-Suite.

Jerry Ippolito, MBA, MHSA reminds us all of the continuous need to attend to the well-being of one’s hospital and surgeons in The Hospital is Your Practice’s Client—Understand Client Satisfaction to Retain Your Contract. As Mr. Ippolito states, “Every business, regardless of its service offering or discipline, must continue to reinvent itself, to remain marketable, in changing times. Anesthesia is no exception.”

The arrival of a new year always brings us coding changes. Kelly Dennis, MBA, who is a certified expert coder with 32 years of experience in anesthesia, reviews the changes to the CPT® system and also to the increasingly frustrating Physician Quality Reporting System (PQRS) in 2016 Coding Updates for Anesthesia. PQRS is now in its penultimate year of existence, and we would like to think that the Merit- Based Incentive Payment System that, in 2019, will replace the various Medicare quality reporting programs bedeviling us today will be an improvement. We shall see.

Confidentiality is a topic that perennially looms large in healthcare. Improving or even maintaining health does not take place in a void; information is and must be shared in order to achieve our health-related goals both as individuals and as participants in healthcare systems. One area that engenders confusion is the extent to which personal information gathered and shared in the context of peer review may be protected from disclosure or “discovery” in legal proceedings. Every state has a statute governing the discoverability of records, reports and conclusions. In Confidentiality in the Peer Review Process: What Does it Mean and What is Covered? Part I, Neda Ryan, Esq. reminds readers of the basic principles and considerations and also provides a summary of the statutes for Alabama through Iowa. Part II will appear in the Spring issue of The Communiqué and will contain summaries for the remaining states.

Just as important a legal matter, although one that comes up somewhat less frequently than confidentiality, is covered by Kathryn Hickner, Esq. in “I’m Out Of Here!” Now What? Physicians leaving a practice are often covered by an employment contract with the group they are leaving and also by federal and state laws regarding employer benefit

We hope that 2016 will be a year of successful and satisfying relationships, old and new, for all our readers.

With best wishes,

Tony Mira
President and CEO