Anesthesiologist Dr. Sterling Wood Discusses Anesthesia Challenges and Opportunities for ASCs

New Jersey-based, board-certified anesthesiologist Sterling "Chip" Wood, MD, partner at Atlantic Ambulatory Anesthesia Associates and executive vice president and chief medical officer of Trinity Surgical Worldwide, discusses challenges and opportunities for anesthesia services in ASCs.

Dr. Wood on the biggest challenges for anesthesia in ASCs…
The biggest challenge anesthesia groups face is probably reimbursement and dealing with issues regarding whether or not to contract with certain payors, and these issues, in turn, can affect ASCs. Deciding to remain an out-of-network anesthesia provider can be challenging because payors may pressure their in-network facilities to contract with in-network anesthesia providers. These decisions make a big difference for us because going in-network will cut our fees considerably. We try to offset these challenges by creating other benefits for the ASC, such as offering cutting-edge anesthesia solutions, which may draw more patients into their center.

On whether ASCs should employ their own anesthesiologists…
In my opinion, most ASCs that are profitable work with an anesthesia group. This is the biggest difference between hospitals and ASCs in regard to anesthesia. Some hospitals provide a salaried wage to their anesthesiologists and there is no real incentive to be efficient. As ASCs look for additional revenue streams, some are considering bringing on salaried anesthesiologists and handling the billing and reimbursement for these services themselves. This type of arrangement promotes a hospital mentality — why should salaried anesthesiologists care if they do one or 20 cases in a day? When you use an anesthesia group, there is an incentive for everyone to be more efficient because it improves everyone's bottom line.

On the best opportunities for anesthesia in ASCs…
The biggest opportunity for anesthesia in ASCs is the advances that anesthesia providers are taking in improving a patient's surgery experience. We are doing a lot of regional and peripheral nerve blocks, which reduce the time patients need to be in the recovery room and help to make their overall experience more pleasant. Patients seek out a better experience and will be attracted to the ASC as a result of this improved experience. Additionally, these types of blocks and pain pumps, which we're using more and more, generate direct revenue for the ASC.

On how ASCs and anesthesiologists can best partner…
Anesthesia groups should be concerned with making themselves as valuable as possible to ASCs. The role of the anesthesia provider has greatly changed over the last few decades. As we move away from salaried models, anesthesia providers have the opportunity to make themselves more valuable to ASCs and other facilities. We're no longer that physician that just sits in the back. There is a lot more opportunity for us to be involved in the whole processes. Now, our groups work with ASCs to market the centers. Because our profitability is linked to the volume and profitability of the ASC, we work with the center to think of ways to bring in more patients. By offering cutting-edge technologies that draw in patients and opportunities for ASCs to generate additional revenue from services, anesthesia groups really can become valuable to ASCs. Our goal is to make our anesthesia group an asset rather than just another piece of necessary "equipment" needed for surgery.