Anesthesia coverage has become one of the most pressing operational challenges facing ASCs today. But according to one expert, most centers are solving for the wrong thing.
Jeff Tieder, MSN, CRNA, a clinical assistant professor at the University of Tennessee at Chattanooga, joined Becker’s to discuss the most common mistakes ASCs make when approaching anesthesia.
The core problem, Mr. Tieder said, is that ASCs treat anesthesia “like a commodity instead of a capacity engine.”
“The No. 1 question they’re asking is: How do we get coverage as cheaply as possible?” he said. “A better question is: What anesthesia group and what model best protects our access to providers, our room flow, our surgeon retention, and our margin over time?”
Choosing an anesthesia provider on cost alone, rather than evaluating the broader strategic picture, is the most common mistake ASCs make, he said. The smarter approach is to assess how an anesthesia arrangement affects overall margin across three to five years, not just the current budget cycle.
“Hospitals and ASCs will throw money at the appearance of a problem rather than the actual problem,” he said. “You might lose a little margin this year because my group is more expensive, but next year, when your reputation is better and your volume and throughput has increased by 20%, costs look much better relative to that.”
Frequent anesthesia group changes compound the problem. When an ASC cycles through providers every year or two, he said, “nobody knows anybody, they’re trying to figure things out, surgeons are frustrated because they can’t get coverage, and everybody’s just angry inside a system that didn’t need to be broken.”
“ASCs are feeling a pinch they haven’t felt in a long time, and rather than treating anesthesia as a short-term supply problem, they have to look at it like a capacity engine,” he said. “Build a good engine, run as much through it as possible. That investment may cost more this year than it “should” — but looking at a three-to-five-year timeline instead of a six-month timeline changes the entire picture.”
A second major mistake is treating anesthesia purely as a cost line item rather than integrating it into the ASC’s overall operations.
“You really have to look beyond just the cost and invest in the service itself,” he said. “Because that’s what we are — we are a service. Yes, we’re expensive, t’s just the nature of where things are right now. Reimbursement is down, the number of anesthesia providers is limited — simple supply and demand economics. Salaries are going to be high.”
As more complex, higher-acuity patients migrate to the ASC setting, Mr. Tieder added, quality should take priority over the lowest bid.
“It’s very easy to fall into that short-term thinking because the margins ASCs are looking at are really tight,” he said. “Gone are the days when ASCs just printed money left and right. They have to look deeper. They have to look beyond just the cost.”
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.