3 tips for navigating cost & coverage in anesthesia

In an interactive session at Becker's 12th Annual CEO + CFO Roundtable, Jeff Terry, executive vice president of strategy and innovation at US Anesthesia Partners (USAP), led a panel discussion on the complexities and challenges in the field of anesthesia, particularly its impact on hospital growth and operations.

Panelists included: 

  • Matthew Stacell, chief performance management officer, Naples (Fla.) Community Hospital
  • Richard Dutton, MD, chief of anesthesiology at University of Maryland Capital Region Medical Center (Lake Arbor, Md.); founder, Anesthesia Quality Institute, American Society of Anesthesiologists; and chief quality officer, USAP
  • Kurt Jones, MD, cardiac anesthesiologist and former chair, USAP Florida Clinical Governance Board
  • Marty Watson, executive vice president of hospital relations, USAP

Leaders shared insights on the evolving landscape of anesthesia services, highlighting the increasing demand, financial pressures for several reasons, and the corresponding necessity for efficient operating room management in general and anesthesia operations in particular. Data analytics, scheduling optimization,expanding care team leverage, and strong site leadership in anesthesia teams were noted as promising solutions to these widespread issues. Panelists also noted innovative solutions such as RN sedation models and the evolution of anesthesiologist roles to include traditional roles covering complex cases, as well as nocturnists and day doctors working at ASCs.

The session underscored the critical role of anesthesia in hospital efficiency and growth, and offered strategies for better integration and management of anesthesia services.

Three takeaways:

1. Anesthesia demand has skyrocketed, placing greater strain on the workforce.

In the last decade, the workload of anesthesia has doubled, Dr. Dutton said — and in his experience, this growth is largely driven by non-operating room business such as interventional radiology, GI and ASCs.

"On top of that, we have now layered on a huge demand," Dr. Dutton said. "And if you want to recruit the best gastroenterologist, the best invasive cardiologist, you have to offer them anesthesia services. That has put stress on our profession. It's what has driven the costs up very rapidly. That's the root of our problem." The increased demand for the anesthesiology is a complement to the profession, but creates stress nonetheless.

2. Anesthesia efficiency and utilization are critical to managing costs and ensuring adequate coverage.

Amid increasing demand for anesthesia, panelists acknowledged challenges of the current economic environment, with Medicare reimbursement rates — adjusted for inflation — down 26% since 2001.

Navigating this, Ms. Watson said, demands a keen focus on efficiency. Health systems should evaluate their current people, processes and data, including careful assessment of subsidy models, billable utilization and how teams are working. 

"If they're not scheduling correctly, then anesthesia utilization is going to be subpar, and then you are paying more for your anesthesia subsidy than what you're getting in return," Ms. Watson said. "You have to have the transparency and the tools from a data perspective to know 'my ORs are running like this, my GI lab is running at this percent,' but how well is anesthesia covering that and how well are they scheduling, because that's where you're going to get your return on investment — looking at anesthesia utilization."

3. Partnerships with anesthesia providers that offer transparency and data-driven insights can help hospitals better manage their anesthesia services.

Mr. Stacell from Naples Community Hospital described how greater visibility to key operational metrics has helped his organization realize improvements in managing anesthesia. "You have to be able to forecast," Mr. Stacell said. "It is a necessity if you're going to grow cases — you have to know what's profitable to you."

Transitioning to a partnership with USAP has provided Naples Community Hospital with another key asset: support for anesthesia efficiency. 

“If you’re going to take on tough efficiency conversations in the OR, anesthesia can be a partner and we’ve found that with USAP” Mr. Stacel said.

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