When most hospital leaders think of accountable care organizations, they may think of large health systems and hospitals, primary care physicians and specialists. What typically do not spring to mind are anesthesia groups. However, an emerging model of anesthesia care in which anesthesiologists expand their role in the perioperative arena can make anesthesia providers valuable to an ACO and other entities focused on high quality and low cost care.
"When you talk about ACOs as your principal new payment modality, most organizations fail to see how an anesthesia group can relate within that model, or what role they would have," says Michael Simon, MD, regional director of North American Partners in Anesthesia and chairman of the department of anesthesiology at UPMC Hamot Medical Center in Erie, Pa. "As a perioperative group, an anesthesia group can impact a hospital, hospital system or ACO's ability to care for its patients and do so in a cost-effective manner."
4 skills of an ACO-worthy anesthesia group
Dr. Simon shares four skills of an anesthesia group that hospitals should look for when including anesthesia providers in an ACO, and how anesthesia providers can enhance quality and reduce costs.
1. Measure quality. To be valuable to an ACO, an anesthesia group needs to have "a very strong history of dedication to quality and outcomes," Dr. Simon says. The group should have the ability to track quality measures, including surgical care improvement project measures and operational measures, such as turnover time, the percent of on-time starts and the percent of cancelled cases. The group then needs to show it uses these measures to guide practice changes that improve performance.
Dr. Simon says anesthesia groups should accumulate a data set that can be used to benchmark performance and drive improvement. Hospitals should ask to see anesthesia groups' quality data to determine their ability to track and meet quality goals. With value-based purchasing and the Readmission Reduction Program now in effect, it is crucial for healthcare organizations to meet standards of quality of care. Anesthesia groups with experience tracking quality data can help hospitals meet these standards and avoid financial penalties.
2. Cut costs. Hospitals should also consider an anesthesia group's ability to deliver care at a lower cost. An anesthesia group that has this ability can have a significant impact on the ACO's overall costs since the perioperative area is responsible for a large portion of a healthcare organization's costs, according to Dr. Simon. The cost of equipment and other supplies is one of the highest cost items in the operating room. Working with an anesthesia group that can arrive at a consensus for cost-effective, high-quality instruments can save a healthcare organization a great deal of money.
In addition, an anesthesia group can lower overall costs to the healthcare organization by driving efficiency in perioperative processes, such as optimizing turnover time and block time.
3. Lead others. Another ability of anesthesia groups hospitals should look at is the capacity to lead others in reaching goals. "You want an anesthesia group that offers very strong leadership within each institution," Dr. Simon says. "You want a chief anesthesiologist willing to take on the entire perioperative arena, from pre-surgical testing through discharge of the patient."
For example, anesthesia providers should ensure all patients have been evaluated prior to surgery to minimize delays and cancellations. Anesthesiologists should also take responsibility for scheduling to optimize block time utilization and increase efficiency.
In addition, anesthesia groups that add value to a hospital or ACO will take responsibility for the postoperative area, including pain management. Proper pain management can improve patient satisfaction scores, which are assessed under value-based purchasing, and decrease length of stay, which can lower costs and optimize capacity.
4. Increase efficiency. An anesthesia group can also be valuable to an ACO if it has experience driving efficiency in the perioperative department. As a perioperative leader, anesthesiologists should ensure cases start on time and help guide patients smoothly from preoperative testing to the intraoperative procedure to postoperative recovery.
Increasing efficiency in this department benefits not only the department itself by increasing the volume of cases it can handle and increasing patient and provider satisfaction, but also the entire hospital. The perioperative department is closely connected to many other services, including emergency services and radiology. By preventing delays in the perioperative area, anesthesia providers can prevent bottlenecks in the emergency department or radiology department.
Considering anesthesia providers as partners
Anesthesia providers who take responsibility for the entire perioperative arena by tracking quality measures, cutting costs, leading processes and increasing efficiency can be valuable to an ACO. With these skills, anesthesia groups can help the hospital and ACO reach quality and cost goals.
"When you talk about ACOs as your principal new payment modality, most organizations fail to see how an anesthesia group can relate within that model, or what role they would have," says Michael Simon, MD, regional director of North American Partners in Anesthesia and chairman of the department of anesthesiology at UPMC Hamot Medical Center in Erie, Pa. "As a perioperative group, an anesthesia group can impact a hospital, hospital system or ACO's ability to care for its patients and do so in a cost-effective manner."4 skills of an ACO-worthy anesthesia group
Dr. Simon shares four skills of an anesthesia group that hospitals should look for when including anesthesia providers in an ACO, and how anesthesia providers can enhance quality and reduce costs.
1. Measure quality. To be valuable to an ACO, an anesthesia group needs to have "a very strong history of dedication to quality and outcomes," Dr. Simon says. The group should have the ability to track quality measures, including surgical care improvement project measures and operational measures, such as turnover time, the percent of on-time starts and the percent of cancelled cases. The group then needs to show it uses these measures to guide practice changes that improve performance.
Dr. Simon says anesthesia groups should accumulate a data set that can be used to benchmark performance and drive improvement. Hospitals should ask to see anesthesia groups' quality data to determine their ability to track and meet quality goals. With value-based purchasing and the Readmission Reduction Program now in effect, it is crucial for healthcare organizations to meet standards of quality of care. Anesthesia groups with experience tracking quality data can help hospitals meet these standards and avoid financial penalties.
2. Cut costs. Hospitals should also consider an anesthesia group's ability to deliver care at a lower cost. An anesthesia group that has this ability can have a significant impact on the ACO's overall costs since the perioperative area is responsible for a large portion of a healthcare organization's costs, according to Dr. Simon. The cost of equipment and other supplies is one of the highest cost items in the operating room. Working with an anesthesia group that can arrive at a consensus for cost-effective, high-quality instruments can save a healthcare organization a great deal of money.
In addition, an anesthesia group can lower overall costs to the healthcare organization by driving efficiency in perioperative processes, such as optimizing turnover time and block time.
3. Lead others. Another ability of anesthesia groups hospitals should look at is the capacity to lead others in reaching goals. "You want an anesthesia group that offers very strong leadership within each institution," Dr. Simon says. "You want a chief anesthesiologist willing to take on the entire perioperative arena, from pre-surgical testing through discharge of the patient."
For example, anesthesia providers should ensure all patients have been evaluated prior to surgery to minimize delays and cancellations. Anesthesiologists should also take responsibility for scheduling to optimize block time utilization and increase efficiency.
In addition, anesthesia groups that add value to a hospital or ACO will take responsibility for the postoperative area, including pain management. Proper pain management can improve patient satisfaction scores, which are assessed under value-based purchasing, and decrease length of stay, which can lower costs and optimize capacity.
4. Increase efficiency. An anesthesia group can also be valuable to an ACO if it has experience driving efficiency in the perioperative department. As a perioperative leader, anesthesiologists should ensure cases start on time and help guide patients smoothly from preoperative testing to the intraoperative procedure to postoperative recovery.
Increasing efficiency in this department benefits not only the department itself by increasing the volume of cases it can handle and increasing patient and provider satisfaction, but also the entire hospital. The perioperative department is closely connected to many other services, including emergency services and radiology. By preventing delays in the perioperative area, anesthesia providers can prevent bottlenecks in the emergency department or radiology department.
Considering anesthesia providers as partners
Anesthesia providers who take responsibility for the entire perioperative arena by tracking quality measures, cutting costs, leading processes and increasing efficiency can be valuable to an ACO. With these skills, anesthesia groups can help the hospital and ACO reach quality and cost goals.
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