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Actionable Information Driving Anesthesia Improvement

October 30, 2019 | 5:10 am | Info Articles
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Current anesthesia trends tell us that the market for anesthesia specialists is and will be experiencing some significant changes in the coming years. Providers and their organizations will be wise to evaluate trends and determine what will be required to ensure their quality of care, outcomes, efficiency and finances remain strong.

Anesthesiologist Talking with Mail Patient
Migration to value-based care is one of the biggest trends in healthcare. Providers have lived in the fee-for-service (FFS) world for so long that the movement to pay-for-performance (P4P) models is forcing many providers to reevaluate how they approach the delivery of care.

A 2018 Change Healthcare study of 120 payers found that about two-thirds of payments are now based on value. It accounting for about 37% of reimbursement in 2018 and is projected to drop below 26% by 2021.

While it’s relatively easy to assess a surgeon’s performance, anesthesia primarily remains a FFS-driven service as there is a struggle to define metrics that show how well anesthesia specialists do their job and if they deserve full payment. The future of anesthesia reimbursement will likely be more closely aligned with P4P and there are organizations such as the Anesthesia Quality Institute that are working to develop quality measures that are relevant to anesthesia. As such measures are defined, we can expect more anesthesia contracts to move away from FFS and toward P4P.

Under the new model of value-based care, providers and anesthesia medical groups are required to invest further into their practice infrastructure and employ data transparency tools and evidence-based documentation methods to remain competitive through their contract negotiations.

Collaborative Care for Optimal Outcomes

Since reimbursement for surgeons and facilities is increasingly tied to outcomes, there is greater pressure to ensure optimal outcomes. Organizations are calling upon their anesthesia providers to become more involved in preoperative care to help optimize patient preparation for surgery. Such a growing reliance on care collaboration may require anesthesia providers to perform more services and interact more closely with patients than in the past. It will be up to providers to determine how to address an expanded role and increasing responsibilities during contract negotiations.

As population demographics shift and the average U.S. life expectancy continues to increase, it is expected that over 60% of the elderly population will suffer from more than one chronic condition. This evolution is expected to have a profound impact on the health care landscape, as providers in both inpatient and outpatient settings prepare for an increase in surgical procedures. While most health care service specialties are poised to grow as a direct result of these changes, the lack of alternatives to anesthesia creates substantial opportunities for practices in the sector.

Anesthesia services produce approximately $19 billion in revenue annually, and that number is set to continue to grow as demand for anesthesiologists increases in tandem with surgical volume. Favorable industry opportunities and demographic profile position anesthesia services to grow for the foreseeable future, and that has attracted a considerable amount of investment.

Growing Reliance on Technology

Two examples of technologies becoming more commonplace and increasingly relied upon by anesthesia providers are anesthesia information management systems (AIMS) and analytics. There are many factors that continue to drive the adoption and use of AIMS, but seven in particular stand out, according to a Mount Sinai Journal of Medicine article citing peer-reviewed journals. The article notes that an AIMS can improve:

  • Reimbursement
  • Quality of care
  • Safety
  • Documentation
  • Translational research

As the market for physician services continues to confront pressures stemming from secular changes within health care as a whole, physician organizations are left to evaluate ways to adapt and thrive in a dynamic environment. Many companies have leveraged merger and acquisition (M&A) strategies to better compete and accelerate growth amidst an industry landscape of changing payment models and shifting competitive dynamics.

Similar to other health care service verticals, the anesthesia specialty has seen waves of consolidation activity driven by both private equity–backed platforms and new market entrants. With the number of significant clinical changes affecting the practice of anesthesiology, it is important for anesthesia specialists and anesthesia medical groups to maintain a comprehensive understanding of the latest advances, risk mitigation strategies and anesthesiology guidelines with specific means to incorporate these updates into practice.

Sources:

3 Anesthesia Market Trends to Watch For. blog.sisfirst.com

Anesthesiology Update 2020. anesthesiology.hmscme.com

Consolidation in the Anesthesiology Services Market Continues with New Partnership Options. anesthesiologynews.com