Somnia Anesthesia recently issued a white paper that addresses, in part, how anesthesia is a key partner in assisting hospitals to comply with the new value-based purchasing (VBP) program requirements by building a foundation for an outcomes-based business model. Somnia also issued a related video white paper focusing on the past, present and future of healthcare reform and the goal of VBP.
Hugh Morgan, Somnia Anesthesia's director of quality assurance and director of the company's Patient Safety Organization, helped author the white paper and presented the video. As part of Somnia's focus on the importance of anesthesia's involvment and impact on VBP, Mr. Morgran discusses five key elements of an anesthesia department that are critical to anesthesia's success in contributing to a hospital's VBP initiatives.
1. Leadership. Successful involvement begins with anesthesia's leadership, Mr. Morgan says. "There's no question anesthesia leadership is a critically important foundation — not just to VBP but to the overall, operational impact of anesthesia throughout the hospital," he says. "Be it in the operating rooms or several other care areas where anesthesia provides services."
2. Partnership. Since VBP is an "all-in initiative where everyone clearly has some skin in the game," Mr. Morgan says, he believes the concept of true partnership is also critical.
"Anesthesia is really aligned and engaged with the hospital in [its] pursuit of achieving the highest levels of outcomes in VBP," he says. "This concept as we know is no longer about just providing services but achieving the highest care outcomes to maximize reimbursement."
3. Transparency. Transparency is vital to ensuring a strong, trusting partnership. "I think the underlying theme of healthcare reform, in addition to accountability [is transparency]," Mr. Morgan says. "Transparency in the sense of anesthesia being viewed as an open book and getting away from this old concept of being a 'black box' — being very transparent in data and outcomes, and sharing that with the hospitals where they are providing services."
4. Accountability. Accountable care is a significant buzz word in healthcare reform, Mr. Morgan says. "It's really this concept of quantifiable quality and being [held] accountable to that."
He says anesthesia groups need to look at and compare themselves on the provider level, and assess their performance and outcomes accordingly.
"As we know, hospitals and health systems have been compared and reported publicly," Mr. Morgan says. "For anesthesia and individual practitioners, I think that's kind of where we are right now. We have to be able to assess performance and outcomes at the individual provider level, look at each individual provider and their outcomes as it relates to what's part of the VBP program."
5. Vigilance. The final critical component Mr. Morgan identifies is vigilance. "Anesthesia really has a critical role in VBP and I think [anesthesia providers] have to be vigilant to their outcomes, not just their performance, and to remain vigilant and to be able to make whatever adjustments are necessary," he says.
Within the VBP program, he says anesthesia is tied to four of the current 12 process of care measures. These measures are not just anesthesia-related, but rather anesthesia-directed or anesthesia accountable measures. Anesthesia is also associated with all of the HCAHPS measures, most directly with pain management.
"In order to maximize a hospital's reimbursement, anesthesia has to nail all of these measures pretty much at 100 percent," Mr. Morgan says. "So clearly anesthesia impacts the hospital's new bottom line and must now be held accountable for quality outcomes. If anesthesia doesn't achieve the highest levels of care outcomes, hospitals are at risk to lose up to 2 percent of their Medicare reimbursement beginning in FY2013. It certainly is a high bar and challenge for anesthesia."
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