Value-Based Anesthesia Care
Even though the traditional fee-for-service (FFS) reimbursement model is still here for now, administrators and healthcare providers should be prepared to shift to value-based care (VBC) models by 2025. To be successful during and after this transition, stakeholders need to have an in-depth understanding of how VBC models work, where opportunities for revenue growth exist and how to mitigate financial risks. VBC models will demand personalized care from all types of healthcare providers—even anesthesiologists and CRNAs.
Linking Cost, Quality and the Patient Experience
Rather than the FFS model that reimburses based on performed services, VBC models pay for health care services in a manner that directly links performance on cost, quality and the patient’s experience of care. Because every patient is unique, a one-size-fits-all approach to care is not an option in VBC models. Rather, VBC models will reward anesthesia providers who meet with patients preoperatively and postoperatively and work hard to ensure that their delivery of anesthesia care meets that patient’s unique needs.
Ensuring Success After Transitioning to Value-Based Care
Transitioning to VBC poses an opportunity for facilities to separate themselves from competitors by demonstrating their ability to deliver reliable, safe, high-quality care at lower costs. Facilities that refuse to realize the shift to VBC risk a decrease in both patient volume and reimbursement. A positive relationship with your anesthesia management group is also essential to success in transitioning to VBC. With tightening reimbursements, stricter regulations and growing competition for patients, well-trained anesthesia providers become more valuable than ever. Since anesthesiologists and CRNAs are often the main communicators with patients perioperatively, they are vital to ensuring patient safety and optimizing patient satisfaction.
Metrics that Matter in Value-Based Care Models
We know how important accurate data is to facility administrators. When the shift to VBC is finalized, the value of metrics will be at an all-time high. A facility’s anesthesia partner should easily be able to track and share key performance indicators in which they played a role. They should also be able to share additional insight into:
- Reasons for case cancellations
- Average recovery times by procedure type
- Operating room turnover times
- Patient satisfaction scores
- Unusual occurrences
- Hospital transfers
- Patient callbacks
- Patient balances
- Postoperative pain and nausea/vomiting
This data will support benchmarking efforts and help to identify opportunities for improvement across the entire clinical workflow.
Value-Based Care Negotiations
Transitioning to VBC models does not mean that negotiations with commercial payers become unnecessary. Our anesthesia billing experts are poised to properly value anesthesia services and our anesthesia providers’ contributions to their facilities in a bundled payment or accountable care organization (ACO). When it comes to budgeting bundled payments or ACO bonuses, delegating funds for anesthesia will be straightforward. We always maintain a commitment to transparent bookkeeping—whether in a FFS or VBC model.
Preparing for the Transition to Value-Based Care
Anesthesia plays a crucial role in transitioning to VBC. If your current anesthesia management group seems out-of-touch with this approaching reality, it may be time to consider other options. The right anesthesia management team can lead to a noticeable advancement in your facility’s patient safety and satisfaction scores while also supporting your bottom line. Our clinical, quality and billing teams are actively working together to anticipate every opportunity for growth presented by VBC.
If you are concerned that your existing anesthesia management group poses risks to your facility’s potential success in transitioning to VBC models, consider moving to CCI Anesthesia. Our anesthesia management experts are available by phone at 844.937.1810 and are eager to discuss our plans for expanding value for our clients.