“Boutique” Anesthesia Services

Kendall R. Lutz
Vice President of Client Services, Anesthesia Business Consultants, LLC, Jackson, MI

I’ve been involved in anesthesia billing and practice management for over 30 years. During that time I’ve witnessed groups of various sizes cover all types of anesthesia services within the hospital environment. Occasionally, a group may have carved out or created a separate chronic pain department, but for the most part, any and all anesthesia services were expected to be covered by the group. Recently however, we have seen a new type of “boutique” anesthesia practice. Is this a new niche in the market, a sliver of opportunity for those who wish to pursue a bit of independence or both?

We are seeing corporations of one to two providers, as well as small groups of 10-20 providers, emerging to cover unique types of cases. Most of these practices operate in offices and surgery centers rendering anesthesia for endoscopy, ophthalmology, dental, orthopedic, plastic, podiatry and chronic pain procedures. Others maintain a hospital presence, including a unique obstetric anesthesia-only group and an independent pediatric anesthesia service.

While this is not entirely new, gastroenterology groups have hired CRNAs for their office-based procedures for years and chronic pain providers have broken away from groups to focus on their specialty, it appears we are seeing more of these unique or boutique anesthesia practices.

Why Pursue Boutique?

There may be many reasons for this new boutique service. For some, it’s the ability to potentially achieve higher earnings while dedicating fewer working hours (equaling an increased hourly value). This could be achieved by limited or no call, unique payer contracts, better OR utilizations or all of the above. For others, it can be as simple as clinical and/ or business autonomy.

Another factor in this new type of business may be the current shortage of both anesthesiologists and CRNAs. This shortage may require current staff to work additional hours with potentially no additional income. Many groups are also attempting to cover multiple locations with limited staff, which can create stress on the already overworked staff. Perhaps this leads to the quest for a better lifestyle.

A third factor appears to be the large national anesthesia groups’ lack of either the desire or staff to cover the needs of the smaller office-based locations.

The boutique businesses are able to focus on managing their smaller practices with fewer group restrictions/distractions. Payer contracts may be negotiated with data that may prove more efficient and less costly care. This can be based on quicker case times, lower facility fees and possibly lower provider cost based on more efficient OR utilization rates. Payer mixes tend to have fewer government payers (particularly less Medicaid) at some of these facilities.

The new boutique models are not without risk. Obviously being a small business in the big business healthcare market can be risky. But there appears, at least at this time, to be a demand and as all entrepreneurs know, there is no reward without some risk.

Kendall R. Lutz, Vice President of Client Services, Anesthesia Business Consultants Kendall R. Lutz, Vice President of Client Services, Anesthesia Business Consultants. Prior to joining ABC, Mr. Lutz was the owner/ CEO of his own anesthesia-specific billing and practice management firm located in the Greater Chicago Area. Mr. Lutz’s 30 years of service to anesthesia providers was highlighted by cutting edge data collection to create time and productivity models used by many in the industry today. Mr. Lutz continues to dig beyond the average billing metrics to find meaningful data to further future anesthesia business models. You can reach him at 847-980-8987 or Kendall.Lutz@AnesthesiaLLC.com.