Ten Questions to Ask: Finding an Anesthesia Partner

What Should an Office-Based Surgical Practice Consider before Taking on an Anesthesia Partner?

Here at The Scope, we’ve talked at great length on how to establish an office-based surgical practice. But how do you find the right anesthesia partner? Today, we’re diving right in so readers like you can move forward with confidence. There are many ways to measure the success of a business in healthcare, especially when providing clinical services. At first glance, KPIs to consider are:

• Accreditation. Is the anesthesia partner you’re considering AAAHC accredited? For how long?
• A strong, publicly shared client retention rate.
• A majority of large clients with long tenures, e.g. 5-10+ years.
• A substantial history of no medical malpractice settlements despite long tenures and/or high case volume.
• A high employee retention rate, signaling service consistency. In a hot clinical job market, looking at companies that retain people for the long haul shows excellent leadership, culture, and compensation, all of which contribute to exceptional customer service for you, the surgical partners.

Starting there, you can be sure that 1) clients value the services; 2) the service quality has remained high, even through growth and, in more recent years, a pandemic; 3) A consistent record of providing patients with safe, high-quality care; and 4) Team members find the work a fulfilling experience, something that always translates to added value for clients.

10 KPIs to Consider for Office-Based Anesthesia Partners

Here are 10 of the most significant benefits to consider — five qualitative and five quantitative.

1. Adapt to Surgeon and Facility Needs.

It’s not just dropping off a doctor or a CRNA. Whatever anesthesia services your practice needs to perform procedures, an anesthesia partner should deliver — and do so seamlessly. Need staff? CRNAs, critical-care trained peri-operative RNs, techs, and anesthesiologists should be available to meet your needs. Worried about the equipment needed for our services and these procedures? An effective anesthesia partner can bring it all, almost operating as a fully autonomous operating suite; monitors, drugs, and supplies, any emergency items. Don’t think you have the space? Anesthesia partners should be able to bring real expertise to provide a solution for any clinical challenge to effectively perform for your patients, whether it’s a strip mall dental office or a urology clinic expanding to offer outpatient surgery. All of the above shouldn’t just happen, it should happen above and beyond regulatory compliance.

Find a partner happy to work with clients to customize their existing space, while also making sure there is no compromise in safety or compliance. A good turnkey anesthesia model is built to be a mobile surgery center to allow you the same, or better, safety standards as a surgery center in the convenience of your office or clinic without the cost or headache.

2. Adapts to Client Schedules and Growth.

We pride ourselves on being as flexible as possible for our clients. We understand that some days are busier than others, and physicians’ schedules are only becoming more volatile. That’s why we work closely with clients to take care of the pre-operative process for them once a patient is scheduled. Our goal is to make the process as easy as possible on the physician and the office staff. Since office-based surgery is experiencing rapid growth as a result of the continued migration from the inpatient setting to achieve cost savings, we’re prepared to support these cases even as they become more invasive. We enjoy helping clients set their offices up for office-based surgical success, and that has created the client partnerships we enjoy years.

We are willing to do an assessment of your facility along with a trial of our services with no additional commitments, so you can see the value and expertise firsthand.

3. Physician Anesthesiologist-Led Model with Exceptional CRNA and RN Team Members.

Anesthesiologists and highly qualified CRNAs, as well as critical care nurses can elevate an entire surgical practice. Anesthesia partners need to be committed to never shortcutting the quality of the personnel they provide to clients. While emergencies are rare, they do happen, and everyone on the care team, from your in-house surgical and clinical team to the anesthesia providers should work in concert to ensure personnel are equipped to step in and handle the situation.

Even in a tense healthcare labor market, it’s imperative to always ask: “Would we want this person caring for us or a loved one?” Because in this setting, there is no “code button” to hit with several emergency personnel jumping in to assist the situation. The gold standard of quality care and emergency preparedness is the minimum.

4. Client Satisfaction.

Anesthesiologists and CRNAs are passionate about their work, and know they keep patients safe and make sure they receive exceptional care. The true test of any outpatient anesthesia partner’s abilities as a service provider is how effectively they work with a practice’s physicians and staff. Remember that client retention point from earlier? Here’s where that shines.

There are several reasons why. You need partners that specialize in office-based surgical care. It’s their bread and butter. They need to treat offices like they are VIPs. Anesthesia groups that specialize in hospital services tend to treat offices like second-class citizens (whether they mean to or not) because it isn’t the most important or focused area of their organization. These groups are happy to take on the work and generate some extra money, but offices are not their top priority or specialty.

The team members an ASC and office-based focused anesthesia partner sends must work effectively and efficiently with office staff and do so in a manner that maintains high client satisfaction. They solely work in this environment and quickly become experts in a quickly growing sector of the industry.

5. Patient Experience.

Patients are the entire purpose of healthcare. Period. An anesthesia partner needs to recognize that, when it comes to providing the most effective provision of care, every patient is unique. This means not just showing up to administer anesthesia, but meeting with patients preoperatively to optimize the delivery of anesthesia to meet these needs. The standard approach needs to take into consideration several factors, the most important being safety. There also needs to be work to reduce anxiety, expedite recovery, eliminate post-op pain and nausea, and minimize cost — much of which is supported by consideration of which drugs to use for which case, e.g. propofol vs other choices, being mindful of the acute need and impact of intubation, etc., to allow patients to remain spontaneously breathing.

6. No Startup or Ongoing Per-Case Expenses.

One of the biggest obstacles to adding anesthesia is the concern of additional cost. That’s why an effective partner eliminates this factor from the equation. Innovative billing models with insurance carriers and federal lines of business like Medicaid means an org should be able to collect fair market value from payers instead of clients. All of the anesthesia-related equipment, supplies and medications — including those for emergency situations like a defibrillator and crash cart — are purchased, managed, brought in, and maintained by the anesthesia partner. For larger groups, this start-up cost and easily amount to $250,000, but not with the right expertise.

7. Optimized Patient Flow.

Processes, approach to workflow, and expertise in administering the optimal anesthetic to achieve the shortest and safest recovery times needs to deliver substantial — and measurable — results. Want to grow your revenue? A top performing anesthesia partner should free up time so that you can do more cases or see more patients in the same number hours. Happy with your revenue? Keep the same number of cases and take advantage of the new available time to do whatever you please. You may be able to reduce costs by shortening staff schedules as well or repurposing them to tackle the growing to-do list in other parts of the practice. The right implementation can lead to upwards of 75% cuts in total patient time at an office for a procedure when compared to other anesthesia services and providers. This is where an anesthesia partner with a strong, comprehensive service model can expand into assisting on facility design and procedural flow.

8. Growing Volume with Ease.

As noted earlier, more — and often higher acuity — procedures are making their way into office-based surgical practices and ASCs in 2023. If physicians are confident in their ability to perform these cases, anesthesia teams need to be prepared to support them. This is why there’s so much emphasis on anesthesiologists, CRNA teams, and critical care trained nurses knowing what’s required to deliver exceptional outcomes with procedures such as UroLift, balloon sinuplasty, shoulder and knee arthroscopy, ACL repairs, total joint replacements, polyp removal, and endometrial ablation. A top performing anesthesia partner should be so obsessed with its work, that they should be able to inform even their surgeon clients of new procedures they may want to consider adding, based on new reimbursement incentives from the insurance carriers and innovations in techniques. Each year there are a list of procedures that offer facility reimbursements to incentive physicians to move procedures from the hospital or ASC where the costs can be exorbitant.

By adding procedures in specialties such as orthopedics or urology, clients can make up for lost revenue as cuts continue to come. Some larger cases can bring in thousands of dollars per procedure. This is a way to protect your practice by bringing in facility-related revenue to your bottom line and taking more control of your patients’ wellness and care.

9. More Money in Your Pocket.

When procedures are performed in the office, all reimbursement stays with the practice’s physicians. This contrasts with performing procedures in a hospital (with reimbursement going to the hospital) or even many ambulatory surgery centers, where physician owners only receive a percentage of the center’s profits. In an office, 100% of the money captured goes to your office. Why give up a larger piece of the entire surgical costs that you have earned and at the same time lower your patients’ out of pocket costs?

10. Advanced Data Tracking.

As the tracking and measurement of data has taken on a greater significance within the industry, anesthesia partners have no excuse not to keep pace. The right anesthesia team should track all key performance indicators, including case cancelations and reasons, recovery time, room turnover, patient satisfaction, unusual occurrences, patient balances, and postoperative nausea/vomiting. This data should then be easily shared and digestible by clients to help support benchmarking efforts and identify opportunities for improvement across the entire clinical workflow. We are always improving and best practices are always at the top of our mind. We can also provide this information to organizations requesting it, such as accrediting bodies and payers as an additional value-add.

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