Scott Mayer, CEO of Rosemont, Ill.-based Ambulatory Anesthesia Care, recently joined Becker’s to discuss the way that his organization is supporting ASCs in finding creative solutions to the industry’s most persistent challenges.
Anesthesia care coordination
A shortage of anesthesia providers continues to be an obstacle in healthcare as demand for surgical procedures increases with an aging population. While opinions remain varied among anesthesia professionals regarding scope-of-practice issues for certified anesthesia assistants and certified registered nurse anesthetists, Mr. Mayer offers a holistic approach to recruitment and staffing that prioritizes the unique needs of each practice.
“It’s a delicate balance between how do you get additional bodies, additional freedoms, additional care team models out there that still are physician-led and prioritize quality and safety, but still also meet the demands of what’s happening today in the environment?” he said. “You have a provider pool situation that is evolving, and people are figuring out and seeing what works to hopefully pop the balloon of pressure of the amount of anesthesia needs that are out there and how to meet those while making sure that quality and safety don’t slip.”
Medicare reimbursement issues
With more Medicare-eligible patients entering the healthcare market each day, Mr. Mayer said that he and his team at AAC work with outpatient centers to help them better manage their anesthesia coverage, scheduling and financial planning for these cases as Medicare reimbursements continue to decline and are already a financial loss for anesthesia.
“One of the things we’re trying to educate the space on is, when you do want to bring the Medicare population in — which we’re happy to service, support and take care of — Are you taking into account that there may need to be some financial stipend or support given to the anesthesia side for that specific patient?” he said.
This differs from the way that many ASCs may be approaching their current anesthesia payment processes as it relates to Medicare patients, specifically, by separating that calculation from a practice’s overall anesthesia billing.
“I feel like people are lumping these bigger, kind of macro situations of, ‘Oh, we need to pay [for] anesthesia …’ when, really, we’re not looking at the root of the problem, which is Medicare reimbursement driven on the anesthesia side, and that utilization needs to be increased as well.”
AAC has been heavily leveraging data analytics and other technologies to bring clarity to these complex billing processes.
“We’ve done a lot to make sure — from EMR, Power BI, from our financial reporting, but also from our operational reporting — to [figure out] how we can get down all the nuances and details as to what could be improved, or where things are standing out,” he said.
“That could be turnover times, volume per surgeon or payer mix. But can you lay that all out with your surgical and client facility partners to say, ‘Here’s the reality, here’s everything that we’re looking at. Here are the facts. What can we do about this to address the situation and to make it sustainable and to make it work for everybody involved?”
Recruitment and retention
One way AAC has managed to recruit and retain high-quality providers is by respecting their desire for independence while emphasizing a tight-knit team environment in an increasingly consolidated healthcare industry.
“I think that there’s a lot of physicians and healthcare workers in general that are trying to gain back some autonomy, some control, some freedom,” Mr. Mayer said. “The consolidators just keep getting bigger, whether it comes to platforms or health systems, it’s definitely becoming more corporate. That’s forced a lot of [providers] — especially on the anesthesia side — to be their own independent contractors.”
While recognizing the roots behind this trend, Mr. Mayer and AAC meet this need with a practice model that offers a supportive, teamwork-focused environment.
“For us, it’s more about how we can give the doctors, healthcare workers, anesthesia providers, what they’re looking for on that side, but also have them as part of a community,” he added. “As a human race and as a population, even in healthcare, we still want to be part of a team. We want to be part of a purpose. We want to feel like we’re on a mission and making an impact. And I think you can do that as a bigger whole.”
To do this, ASCs and other outpatient centers must respond to the shifting needs of anesthesia professionals, from compensation to schedule flexibility.
“What we’re really trying to do is empower our staff and our people to feel like not only they have a voice, but that there’s clinical autonomy, that there’s flexibility, so that they see that they’re part of of this migration and this movement to a future value-based care model of lower cost savings, higher satisfaction and increased access to care,” Mr. Mayer said. “We’ve got to be intentional with our individuals. We’ve got to show that we really want the best for this organization in many different ways and for them as people as well.”
