The healthcare industry's move from a focus on productivity to a focus on value has led to many new models for care. The accountable care organization is a new model that encourages healthcare providers to partner to achieve greater quality at a lower cost. The pressure to partner with hospitals and other providers is leading anesthesia groups to change from independent practices to managers of the entire perioperative department.
"An anesthesia group can morph itself into a perioperative group," says Michael Simon, MD, regional director of North American Partners in Anesthesia and chairman of the department of anesthesiology at UPMC Hamot Medical Center in Erie, Pa. By transitioning to a group that extends its responsibilities and focuses on transparency and accountability, anesthesia providers can ensure their relevance and survival in a pay-for-performance world.
5 differences between the old and new models
Here are five ways the new, emerging model of anesthesia providers differs from the traditional model.
1. Structure. In the older model, an anesthesia group consisted of a partnership of equals, with no designated leaders. Newer models have "clear accountability where the chief anesthesiologist is empowered and responsible to effect meaningful change for an entire perioperative arena," Dr. Simon says. This accountability model can provide value to an ACO or other value-oriented organization by focusing on individual and group responsibility for quality and cost outcomes.
2. Operation. In the new model of anesthesia delivery, anesthesia groups will also take on more responsibility. "In the older model, the operating room was almost a standalone entity, and anesthesia groups looked to just give that service, not to add on other business [responsibilities]," Dr. Simon says. The future model will break down silos and integrate the perioperative department with other services, which will require anesthesiologists to work more closely with other providers. By taking on responsibility for the entire perioperative service, from pre-surgery to discharge, anesthesia providers can help create efficiencies and ensure quality.
3. Alignment. "In the older, more traditional style, anesthesia groups operate in a vacuum, not really considering the benefits of alignment between hospitals, surgeons and nursing," Dr. Simon says. "In the future paradigm — an accountable care model — a group works collaboratively with hospital administrators, surgeons and the entire perioperative team to make sure they all have aligned goals." By aligning goals with other providers, an anesthesia group can develop strategies to reach quality and cost goals.
4. Metrics. The newer model of anesthesia will be more focused on quality metrics, which will determine a portion of payments to ACOs and hospitals. Meeting quality goals will require "a more protocol-driven, standardized system," Dr. Simon says. Anesthesia groups will also need to benchmark data against their peers to drive improvement.
5. Case assignment. Traditionally, physicians were assigned to cases based on their placement in the rotation. In the new model, physicians will be assigned based on expertise and competencies, according to Dr. Simon. This method can improve quality by ensuring physicians are expert in their cases.
Transitioning from the old to new model
The transition from the traditional to new model of anesthesia care may be particularly difficult for smaller anesthesia groups, which may not have the resources and infrastructure to meet new demands of quality and cost. Dr. Simon suggests smaller anesthesia groups are likely to need to partner with larger entities to provide high-quality, cost-effective care. "It doesn't mean they can't exist as small entities, but they need to be ready to do all the things the larger groups are doing," he says.
By changing the traditional model, anesthesia groups can make themselves indispensable to ACOs and other value-based systems.
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"An anesthesia group can morph itself into a perioperative group," says Michael Simon, MD, regional director of North American Partners in Anesthesia and chairman of the department of anesthesiology at UPMC Hamot Medical Center in Erie, Pa. By transitioning to a group that extends its responsibilities and focuses on transparency and accountability, anesthesia providers can ensure their relevance and survival in a pay-for-performance world. 5 differences between the old and new models
Here are five ways the new, emerging model of anesthesia providers differs from the traditional model.
1. Structure. In the older model, an anesthesia group consisted of a partnership of equals, with no designated leaders. Newer models have "clear accountability where the chief anesthesiologist is empowered and responsible to effect meaningful change for an entire perioperative arena," Dr. Simon says. This accountability model can provide value to an ACO or other value-oriented organization by focusing on individual and group responsibility for quality and cost outcomes.
2. Operation. In the new model of anesthesia delivery, anesthesia groups will also take on more responsibility. "In the older model, the operating room was almost a standalone entity, and anesthesia groups looked to just give that service, not to add on other business [responsibilities]," Dr. Simon says. The future model will break down silos and integrate the perioperative department with other services, which will require anesthesiologists to work more closely with other providers. By taking on responsibility for the entire perioperative service, from pre-surgery to discharge, anesthesia providers can help create efficiencies and ensure quality.
3. Alignment. "In the older, more traditional style, anesthesia groups operate in a vacuum, not really considering the benefits of alignment between hospitals, surgeons and nursing," Dr. Simon says. "In the future paradigm — an accountable care model — a group works collaboratively with hospital administrators, surgeons and the entire perioperative team to make sure they all have aligned goals." By aligning goals with other providers, an anesthesia group can develop strategies to reach quality and cost goals.
4. Metrics. The newer model of anesthesia will be more focused on quality metrics, which will determine a portion of payments to ACOs and hospitals. Meeting quality goals will require "a more protocol-driven, standardized system," Dr. Simon says. Anesthesia groups will also need to benchmark data against their peers to drive improvement.
5. Case assignment. Traditionally, physicians were assigned to cases based on their placement in the rotation. In the new model, physicians will be assigned based on expertise and competencies, according to Dr. Simon. This method can improve quality by ensuring physicians are expert in their cases.
Transitioning from the old to new model
The transition from the traditional to new model of anesthesia care may be particularly difficult for smaller anesthesia groups, which may not have the resources and infrastructure to meet new demands of quality and cost. Dr. Simon suggests smaller anesthesia groups are likely to need to partner with larger entities to provide high-quality, cost-effective care. "It doesn't mean they can't exist as small entities, but they need to be ready to do all the things the larger groups are doing," he says.
By changing the traditional model, anesthesia groups can make themselves indispensable to ACOs and other value-based systems.
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