Careers in Anesthesia are Changing, with Opportunities Outside Hospitals
Careers in anesthesia treating non-hospital patients is at the cutting edge of technique and skill while offering greater work-life balance.
AMITA on the the role of private equity in transforming healthcare
Elyse Cutler, Chief Strategy Officer, AMITA, and Don Franke, SVP for Population Health CEO, with AMITA Healthcare Network, give us insights into the role of private equity in transforming healthcare, the core aims of value-based care, and why change has been so slow to come.
What innovations in the last 1-3 years do you feel will permanently change the healthcare industry and why?
Cutler: While it’s not an innovation in the traditional sense, COVID as a novel virus will have the biggest and longest-range impact on our industry well into the future. For example, we now have widespread use of virtual visits across the industry, and we are seeing less inappropriate emergency-room use. At the same time, the disproportionate impact of COVID on low-income communities of color has brought attention to the inequities in the health care system. We all have a responsibility as health care leaders to address these inequities.
Who (organizations or people) are the most meaningful disruptors in healthcare today and why have others failed?
Cutler: The private-equity sector is having a significant impact on the health care system today. These funders are investing millions of dollars to “transform” health care. The jury is out on how these entities will impact the industry over the long-term.
What does value-based care mean to you? Can you provide us with some examples in action?
Franke: Value-based care is based in a foundation of provider accountability related to patient outcomes. Our focus in value-based arrangements is driven by the quadruple aim – reducing total cost of care provided, improving the quality and outcomes, improving patient experience/satisfaction in the care they receive, and enhancing the provider experience in working within the parameters of the program. Typically in a value-based arrangement with a payor AMITA:
- Receives a list of attributed patients for whom we are accountable
- We accept responsibility to drive cost to an acceptable medical loss ratio (premium ÷ claim expense)
- We agree to a set of quality metrics that are appropriately focused on the population for which we have accountability (i.e. colonoscopies for >50, childhood vaccines for <18, etc.)
- We agree to bi-directional data-sharing of quality, cost and outcome data (non PHI) amongst all providers participating in the arrangement and with the insurance company
- There is a significant focus on accurate coding of services and diagnosis to generate appropriate risk scores for patients in order to stratify the intensity of focus on specific patients and issues
- Medication adherence is a key focus
- There are opportunities to participate in sharing of any savings that are generated as a result of the rigor around managing the care for these patient populations
What are the biggest challenges and obstacles to making your vision of a value-based care future a reality?
Cutler: I started working on value-based care in 2010 and, unfortunately, not much has changed in the industry over that time. The financial incentives to provide high cost, high-intensity care still fundamentally exist across the industry.
Where do you like getting your industry news from? Which industry thought leaders do you listen to and why?
Cutler: The New York Times, the Wall Street Journal and Politico Pulse.
Recent Posts 
How office-based procedures can impact nursing burnout
With a nursing burnout crisis not looming, but here, what role can office-based procedures play in reducing stress?
Dr. Heike Knorpp on the importance of trust
Mobile Anesthesiologists' Dr. Heike Knorpp shares her insights on trust in the physician-patient relationship and how office-based procedures can impact that.
Dr. Meghan Valach on physician burnout and finding freedom
Alarms have long been sounding about the looming physician burnout crisis facing healthcare and the nation at-large. The pandemic only intensified feelings of depression, depersonalization, lack of professional satisfaction, and emotional exhaustion. The American Medical Association recent reported on findings of a Mayo Clinic study that found during the Omicron wave of the pandemic, a...
How expanding sites of service can benefit everyone
Expanding - not disrupting - sites of service broadens access while bringing down overall costs.
Dr. BobbieJean Sweitzer on the advances of ambulatory anesthesiology
Dr. BobbieJean Sweitzer, past president of the Society for Ambulatory Anesthesiology (SAMBA), shares her insights on where the field is going
The intersection of patient safety and office-based procedures
Dr. David Mayer shares insights into how critical protocols and safeguards can ensure office-based procedures and patient safety align.
How office-based procedures embody the spirit of the quadruple aim
Moving procedures into the office setting checks all the boxes when it comes to the quadruple aim.
AMS’ Tina Mentz on the importance of cost transparency
Cost transparency benefits patients, providers, and payers, so why is the industry so averse to it? Tina Mentz share her thoughts on the importance of sunlight in healthcare spending.
What health systems can gain from shifting sites of service?
Health systems need to differentiate from new players offering easier access and lower costs. Office-based procedures could be the key.
What opportunities do office-based procedures present in urology?
Office-based procedures have a proven track record of safety and myriad benefits for urologists, patients, and payers alike.
Could office-based procedures be the key to growing your practice?
Office-based procedures are growing in popularity as a way for independent practices to grow. So what are the benefits and key considerations physicians must make to safely bring procedures into their own space?
One doctor’s novel approach to bringing down healthcare costs
Armed with a commonsense approach to lowering healthcare costs, anesthesiologist Dr. Marlon Michel is safely, conveniently, and comfortable helping dentists shift their sites-of-service.
What are some of the fastest-growing medical procedures performed in the office space?
More-and-more, medical procedures are being performed safely, conveniently, and affordably in physician's offices and clinics.
4 Reasons Why Part III: Changing Industry and Demographics
Today's post is part III of our ongoing series about moving procedures out of the hospital and into ambulatory surgery center and office-based environments. Today, we're discussing changing patient demographics and market signals.
4 Reasons Why Part II: The Evolution of Office Healthcare Technology
Today's post is part II of our ongoing series about moving procedures out of the hospital and into ambulatory surgery center and office-based environments. We're discussing the contributing factors to the site of service shift, and its benefits to patients and doctors alike. Last week, we covered advances in surgical procedures and anesthesia. This time, we're addressing the rise of office healthcare technology.
4 Reasons Why: Moving Procedures in-Office.
Reason #1: ADVANCES IN ANESTHESIA AND SURGICAL PROCEDURES The modernization of anesthesia, particularly outsourced anesthesia, has played a clear role in the site of service transition to office-based procedures. The healthcare industry is undergoing a dramatic transformation. The past decade has seen a steady increase in surgical procedures moving away from hospital environments into surgery...