Quality over Cost over Time

The current fee for service (FFS) reimbursement model incentivizes providers of health care services for “doing more.”  The more tests ordered, patients, seen, or procedures completed result in increased service revenue.  The FFS reimbursement model under the Affordable Care Act (ACA) is unsustainable.  The Dartmouth Atlas of Health Care has shown a 250% variation in FFS charges on national Medicare spending, even after adjusting for individual healthcare variations.  This regional variation is confounding and unwarranted.  Individuals who live in areas where Medicare expands more per capita do not receive more care or posses a higher risk index.  However, most concerning is the fact that there is no evidence of better health outcomes relative to the higher cost expenditures.  The Office of Inspector General (OIG) reinforced the disparity in allocation of Medicare payment to Hospitals in its “Medcare Hospital Outlier Payments Warrant Increased Scrutiny¹” report. 

Higher cost, equal outcomes, is unacceptable for any healthcare service. Your anesthesia service provider is no exception.

Executive Anesthesia Solutions (EAS) recognizes the disconnection in cost versus outcome and focuses on (1) unmatched quality and (2) better outcomes at fair market value. 

In April of 2013 CMS Administrator Marilyn B. Tavenner spoke to the Senate Finance Committee on the advent and implementation of alternative payment model²: 

“the Bundled Payments for Care Improvement initiatives is comprised of four broadly defined models of care, which link payments for multiple services beneficiaries receive during an episode of care. We think episode based payment has great potential to transform the delivery system. We are confident that these initiatives will enable the Congress to build a reformed physician payment system.”

How can we improve if we don’t understand how?

A vital component of value-based care is understanding value measurements and incorporation of value based performance tools in to daily care regimes.  EAS is composed of individuals who possess advanced training in clinical delivery, health policy, accounting, finance, process/industrial engineering, translational research, and strategic leadership.  

Does your facility currently retain experts in alternative payment model implementation?

A focus of healthcare reform is to track value measures (e.g. PQRI, SCHIP, HCAHPS) we at EAS understand that performance based reimbursement, episode based payment models, and alternative compensation delivery models will be the future.  EAS is a vested anesthesia partner that understands how to maximize patient outcomes, refine institutional efficiency, and increase surgeon, facility, and patient satisfaction scores. 

1. Department of Health and Human Services, Office of Inspector     General (2013). Medicare Hospital Outlier Payments Warrant Increased Scrutiny. November 2013. Retrieved from: http://oig.hhs.gov/oei/reports/oei-06-10-00520.pdf
2. United States Senate Committee on Finance (2013). Nomination Hearing for Marily B. Tavenner to be Administrator of the Centers for Medicare and Medicaid Services April 9, 2013, Questions for Marilyn Tavenner. Retrieved from: http://www.finance.senate.gov/imo/media/doc/04152013 Tavenner QFRs1.pdf

How Executive Anesthesia Solutions Address Client’s Needs:

• Executive Anesthesia Solutions leadership and depth of expertise draws on healthcare industry leaders that streamline integration of clinical and healthcare business solutions.
• Evidence based clinical and business management tools that focus on OR management utilization and the clinical productivity of client’s facilities
• Customizable client focused approach that incorporates flexibility and teamwork centered practice dynamics
• Facilities can have the assurance of knowing that their OR will have appropriate staffing coverage and productivity will not be compromised
• Executive Anesthesia Solutions extensive network of clinicians and business professionals ensure industry leading standards are met or exceeded for all clients

What you can expect as an Executive Anesthesia Solutions Client:

• Reduced anesthesia subsidy and surgery related costs
• Improved anesthesia leadership
• Improved service, quality reporting, and regulatory compliance readiness
• Each facility will experience a smooth transition from current anesthesia practice group to Executive Anesthesia Solutions.  Prior to initiation of any contract the following will occur
• A transition team consisting of an anesthesia operations director, a credentialing specialist, a clinical compliance manager, a billing/collection analyst, a financial analyst, and a process engineer will conduct a needs assessment and develop an implementation strategy
• A business plan customized to the facilities specific clinical and business needs/goals will be created
• After assessing and evaluating staffing retention and recruitment needs, a recruitment & retention (R&R) plan will be created to ensure appropriate levels of staffing and elasticity
• Through regularly scheduled meetings, facility leadership teams will have constant access to the Executive Anesthesia Solutions team to discuss the transition and implementation of anesthesia services in congruence with clients practice needs.