How Anesthesia Providers Impact Physician Office Value-based Care

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Healthcare is continuing its slow, but inevitable transformation away from the traditional fee-for-service payment models to value-based care. This shift ensures providers focus on improving outcomes and the quality of care a patient receives rather than volume of cases, while also improving access to care across the board. The question is how can this reach the physician’s office? Will Value-based care make it to independent practices in a meaningful way?

While there are public perceptions that these reimbursement models pay less, “pennies on the dollar,” the reality is the opposite, if a physician’s office can engage with value-based contracts directly with CMS via the REACH program (which, in turn, gives them access to risk-based payments). Speaking frankly, an ability to understand and engage with these programs gives physicians with office-based surgical practices to separate themselves from the competition. Practices that demonstrate their ability to consistently deliver safe, high-quality care can expect to thrive. Those that don’t, can expect to see a decrease in both patient volume and revenue reimbursement. Anesthesiologists, an often-overlooked component in the office-based, surgical setting, will play an important role in guaranteeing success in the new value-based care environment.

Let’s cover how.

WELL-TRAINED STAFF

In the office-based surgical setting there is no “code button” to hit with several emergency personnel jumping in to assist when a situation occurs. With this knowledge, well -trained staff equipped to handle any and all situations as a part of an anesthesiology partnership is key to ensuring patient safety and satisfaction.

Additionally, critical care nurses, and the emergency medications and equipment to be prepared for any and all situation, should be capable of meeting or beating the standard of care at an ambulatory surgery center.

All that said, preparation includes strategy and understanding, that means individualized approaches to patient care, meeting with patients pre- and postoperatively to ensure the delivery of anesthesia meets each patient’s unique needs. The right partner should work to reduce anxiety, expedite recovery, and eliminate post-op pain and nausea while minimizing cost. From a larger, systemic perspective this can bring the physician’s office closer to value-based care by simply ensuring that outcomes can surpass other sites of service, not just providing for patients, but by further ensuring the longevity and good standing of the practice itself.

ADVANCED DATA TRACKING

In an era where data rules everything, this is only going to accelerate through the greater adoption of value-based contracts. The burden of that data, at least the anesthesia component, should be able to fall to the anesthesiology partner with confidence. Any team coming into help serve and grow an office-based practice should be capable of tracking all key performance indicators, including case cancelations and reasons, recovery time, room turnover, patient experience, unusual occurrences, patient costs, and postoperative nausea/vomiting, many of which can be helpful in calculating quality scores and being ready in the event of a RADV audit. Additionally, access to the data will help any practice recognize pain points and either increase headcount or refine patient throughput to improve not just patient outcomes, but quality of life for their team. Finally, this data is invaluable to accrediting bodies, national surgical associations, and insurance carriers as an additional value-add.

While there are still many unknowns when it comes to value-based care, one thing that is certain, patient safety and experience will be essential to succeed in today’s consumer-driven healthcare market. With tightening reimbursement, stricter regulations and growing competition for patients, a less-than-optimal anesthesia and surgical partner will no longer cut it. The Scope’s partner practices are the only solution in the growing office-based setting.