NorthStar Anesthesia's CEO on reimbursement challenges, growth opportunities

Adam Spiegel, CEO of NorthStar Anesthesia, spoke with Becker's ASC Review on the biggest opportunities for growth in anesthesia. 

Question: What’s the most significant opportunity for growth in anesthesiology?

Adam Spiegel: The biggest opportunity for growth in anesthesiology is following surgical volumes to nonhospital settings, like ASCs and, increasingly, physician offices. On the hospital side, anesthesia will also be used in more nonoperating room anesthesia sites, such as endoscopy, cardiac catheterization lab, electrophysiology lab, interventional radiology, etc.

This trend does not come without its challenges, as the anesthesia community will continue to be faced with a greater number of patients with multiple comorbidities in the noninpatient operating room environment.

Q: What are the biggest reimbursement challenges in anesthesiology?

AS: Anesthesia providers faced a significant Medicare reimbursement cut in 2021 in the midst of providing critical COVID-19 patient care services across operating rooms, ICUs and airway intubation needs. Coupled with nonstandard surprising billing legislation across the United States, it has been a challenging reimbursement environment for anesthesia.

The ability for insurance companies to terminate managed care contracts that may be favorable to an anesthesia group so that the "median" market rate becomes the new rate for the group will put more financial pressure on anesthesia groups as well as their hospital partners. We believe payers and clinicians can find common ground in value-based care arrangements that have sadly been slow to come to anesthesia. Anesthesia-led initiatives can improve surgical outcomes to the benefit of patients, providers and payers, but we need increased engagement from payers to implement these models broadly.

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