Payers are actively embrace the office-based setting for surgical procedures, as demonstrated by changes in office and ASC costs. The last few years have seen increased incentives to shift procedures from hospitals or ASCs to the office. New procedures are added to the incentive list regularly, including the most recent additions of cardiovascular stents, urolifts, myomectomy and fibroid removal, and ear tubes. Multiple carriers across the US also increased their incentive payment to encourage proceduralists to shift their procedures from the hospital or ASC to the office in 2023.
With reimbursements and types of procedures that can be performed in-office on the rise, it is essential that your procedure days are as efficient as possible. Fundamentally, for these second and third sites of service, the clinical goal is the same as the hospital: provide exceptional care to as many people as possible in the name of chipping away at the backlog of necessary procedures impacting patient quality of life. By expanding the places these outpatient procedures can be done safely and effectively, it further frees up hospital resources for more complex, serious cases. However, it’s more than just creating additional paths to treatment, it’s also about knowing how to avoid the mistakes or large organizational structures that hospitals with hundreds of beds demand.
For the Scope’s ambulatory anesthesia partner practices, this means helping surgeons and proceduralists in ASCs and offices maximize patient flow by providing a critical-care trained, ACLS-certified nurse to provide all pre, intra, and postoperative care. These nurses can conduct pre-operative screening assessments, including COVID screenings, on all scheduled patients prior to the procedure day to ensure appropriate patient selection and reduce procedure day cancellations. Then, anesthesiologists can apply procedure-specific anesthesia techniques to reduce instances of PONV and minimizes “sedation hangover,” resulting in shorter recovery times. As a result, this means surgeons can perform 30-50% more cases in the same block of time they were doing procedures in previously. Time and convenience are more valuable than ever and this optimizes both for the physician, the practice at large, and above all else, the patient.
From a cost perspective, this model ensures physician partners do not bear the costs of any start-up or ongoing costs related to anesthesia. Each procedure day, all anesthesia-related supplies, medications, equipment, and emergency resources (e.g., crash cart, Dantrolene) needed, are brought in by the anesthesia practice. While each specialty varies, our physician partners experience savings upwards of $200K per year for both nursing and anesthesia-related items. Larger practices and facilities often see millions of dollars in savings per year after growing their office-based procedure platform with our partners, radically lowering office-based and ASC costs.
Every dollar counts, and these cost savings and throughput improvements help doctors treat more patients, and patients get seen faster in a safe, appropriate environment for their procedure while also reducing the cost of care for the patient. Fundamentally, practices are (or should be) patient advocates. Anesthesia partners like ours boast a 99% in-network claim processing, which means no surprise billing for patients, with 65% of patients paying $0 for office-based anesthesia and 85% paying less than $100. This is the definition of value-based care and the future of the industry.
The model they employ alleviates the unnecessary headaches associated with anesthesiologist and pre/post-op nurse staffing and the costs associated with providing the related medications, supplies, and equipment. Put another way, anesthesia partners like these absorb all the complexity to provide the most streamlined experience possible for their clients and patients. That’s probably why Mobile in Chicago, Noble in Texas, and M2 in the Pacific Northwest, boast a 99% client retention rate.
Portions of this piece on anesthesia and value-based care were originally published by Scope partner practice Mobile Anesthesiologists in Becker’s ASC review. It has been updated to reflect policy changes by CMS and changing landscape of non-hospital surgical care. While the backbone of value-based care is primary care and preventative medicine, inevitably surgical intervention is...
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