What's the biggest opportunity for growth in anesthesiology?

For one CEO, the biggest opportunity for growth is a joint venture between ASC owners and anesthesia providers. 

Five leaders in anesthesiology spoke with Becker's ASC Review on the biggest growth opportunities within the industry. 

Editor's note: These answers were edited lightly for clarity.

Question: What's the biggest opportunity for growth in anesthesiology? 

Darin Rentz, DO. CEO of Ortho Anesthesia Specialists: I see the biggest opportunity for growth in anesthesia is a joint venture between anesthesia and surgery center owners. This enables a synergistic approach to increase throughput, decrease narcotic utilization, control pharmaceutical cost, have dedicated anesthesia providers and improve patient care and experience.

Andrew Leibowitz, MD. Professor and Chair of the Department of Anesthesiology, Perioperative & Pain Medicine at Mount Sinai Health System (New York City): Anesthesiology practices with a large governmental payer mix require a substantive subsidy from the sites they staff. Anesthesiologists may provide, on average, 10,000 to 15,000 [American Society of Anesthesiologists] relative value units of work per year. In most states, Medicaid pays approximately half what Medicare does. So, the biggest reimbursement challenge is to not succumb with commercial payers to a "multiple of Medicare contract" when Medicare is so grossly underpaying anesthesiologists to begin with. Further, many anesthesiology groups have experienced commercial payer contracts unilaterally revoked and rates significantly decreased before the end of the written contract cycle.   

Mark Casner. CEO of Providence Anesthesiology Associates (Charlotte, N.C.): At the risk of stating the obvious, our best growth opportunities are at the ASC level, as well as office-based anesthesia.

Scott Harper, MD. Assistant Professor of the Department of Anesthesiology and Perioperative Medicine at University of Alabama at Birmingham: Obviously, ASCs are growing by leaps and bounds, and it appears that will continue for the foreseeable future. 

Jonathan Beathe, MD. Assistant Clinical Director of the Department of Anesthesiology at the Hospital for Special Surgery (New York City): One of the biggest opportunities for growth in the field of anesthesiology is improving the experience of care postdischarge. With trends toward shorter length of stay and the disruptive innovation of telemedicine, there is tremendous opportunity for anesthesiologists to demonstrate our value. Modernized analgesic strategies that minimize or even eliminate the use of opioids, including the use of continuous peripheral nerve blocks, have the added potential benefit of reducing the incidence of chronic postsurgical pain. As the trend toward outpatient total joint replacements continues, it is not enough to be satisfied with acceptable patient safety metrics. At my institution, we continue to optimize enhanced recovery pathways to focus on outcomes that matter to our patients. 

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