Review Your Anesthesia Staffing Model
Your anesthesia staffing model may be one of the most important elements influencing your hospital’s profitability (or lack thereof). Not only does it determine how many anesthesia provider salaries you are paying, but it also impacts billing rules and affects reimbursement. Considering its effect on your facility’s financial health and other vital metrics like surgeon satisfaction and first case on-time starts, it is a good idea to critically review your anesthesia staffing model regularly.
Elements of a Sensible Anesthesia Staffing Model
Determining the best anesthesia staffing model for your facility can be tricky, as it should be custom-tailored to meet your exact needs. Ultimately, your anesthesia staffing model should:
- Organize variables unique to your facility or system while assessing requirements for best practices.
- Limit service duplication, improve effectiveness, increase access and reduce costs.
- Bolster quality and safety initiatives.
Choosing Between Medical Direction and Medical Supervision
The decision between billing services under medical direction or medical supervision can significantly affect your anesthesia staffing model. Medical direction occurs when an anesthesiologist is concurrently supervising and involved in no more than four active anesthesia procedures. Medical supervision occurs when the anesthesiologist cannot perform all seven documentation requirements for billing medical direction. This means that CMS pays the physician for only three units, with one additional unit being made available if the physician was present on induction. The CRNA still uses the qualified non-physician modifier and is paid 50% of the total allowed amount. Your anesthesia management group should be able to determine the best, most compliant way to bill for anesthesia services that supports your bottom line the most.
Alternative Staffing Models for Opt-Out States
Keep in mind that medical direction or medical supervision is not always required. In “opt-out” states, CRNAs can legally provide anesthesia care without medical direction or medical supervision. Rest assured that studies have proven that increasing CRNA involvement and reducing restrictions on CRNA-provided services results in care as safe and equitable as that delivered by anesthesiologists or in more restrictive models. CRNAs provide most anesthesia services in rural America and often work in areas with vulnerable populations. CRNA care may result in cost savings and reallocating budget dollars to additional coverage for anesthesia services and/or other crucial healthcare areas.
Making Anesthesia More Cost-Effective and Accessible
If your facility prioritizes making anesthesia care more cost-effective and accessible, take these steps:
- Understand your state’s practice laws for the anesthesia department and CRNAs. If you are in an opt-out state, consider transitioning to an all-CRNA practice knowing that CRNAs provide effective, efficient and equitable anesthesia care.
- Review your facility’s medical or professional bylaws, rules and regulations and anesthesia policies that may restrict efficiency. Work to eliminate restrictions that exceed federal and state laws and create practice barriers for CRNAs.
- Understand your community’s interests and your stakeholders’ concerns.
- Know how to evaluate your anesthesia business and take back control.
Knowledge is Power
Resistance to change is normal, but changing your anesthesia staffing model could result in significant savings annually. At CCI Anesthesia, we routinely implement new staffing models at the facilities we serve and are experienced in achieving stakeholder buy-in. We also maintain an open-book policy for our clients so they can easily see where every dollar is being spent. By arming our clients with this knowledge, we enable them to take back control of their anesthesia expenses. If you sense that it’s time to implement positive changes in your anesthesia department, allow us to help. Contact us today at 800-494-3948, and we can share more insight into how a staffing model change at your facility could balance your budget.