My mission in healthcare

has always been to provide quality clinicians with the optimal behind the scenes support and business oversight to maximize their impact on the patient experience and delivery of care. In order to run an efficient and profitable anesthesia practice, a leader must take away the administrative, business, and insurance noise that clinicians face and allow them to focus solely on building a solid clinical practice and an extraordinary patient experience. Quality and safety are the core to any clinical practice. Anesthesia is present in the ambulatory environment to protect the patient and improve their experience. Most procedures are elective and the level of anesthesia varies depending on the invasiveness of the surgery. The level of acuity of procedures in this non-acute environment continues to increase and not all patients and circumstances are appropriate given the lack of emergency resources available.

To provide a safe, quality environment in the ambulatory setting, you must:

  • Ensure anesthesia is involved in the pre-operative patient screening process for all patients. The additional time and resources required to support this process yields optimal patient selection and greater client retention.
  • Educate your ambulatory clients on appropriate patient selection guidelines and types of procedures to avoid day-of cancellations.
  • Select anesthesia providers committed to the patient first mission, despite potential disagreements with surgeons or facilities on patient selection.

An anesthesia practice with solid clinical policies and patient selection criteria that set proper expectations with their ambulatory clientele experience cleaner malpractice claim histories (and therefore, lower premiums), greater client retention (the procurement cost for a new client is 10 times greater than retaining an existing client), and more new opportunities as a result of better patient experience and outcomes. Your practice’s performance and outcomes can become the standard in the ambulatory space. Sharing your outcomes and quality metrics with payers in this value-based environment will result in greater leverage when negotiating with payers.

My job, as the business and financial leader of the practice, is to focus on the key metrics that in my experience, make an anesthesia practice successful. Given the ambulatory market’s growth and improved payer mix over the hospital setting, some would assume that the financial model is easier and more forgiving in this setting. Unfortunately, it is the opposite. You have smaller physician practices and facilities battling for patients. They also are balancing politics, surgeons’ schedules, resource and staffing costs, hospital coverage, etc. so it is a puzzle where efficiency, convenience, and financial optimization are always prioritized. Because of this, anesthesia has an even thinner margin for error.

You must continually ask yourself:

  • Are you getting the caseload per provider that you need to cover costs?
  • Are you tracking data to see a blended average of profitability versus looking at things day to day?
  • Have you promised your center or client coverage for any and all cases that leaves you vulnerable to covering one or two case schedules that cause you to lose money?
  • How are you balancing your customer service with financial needs?

A successful group is making sure that they not only optimizing the production of their providers and team, but also understanding physician burnout. Can you work with your clients to set proper expectations, have safeguards with stipends or subsidies if low volume coverage is needed, and also put your anesthesia providers in settings and with schedules that allow you to cover your costs? This needs to be carefully managed on all ends, making sure that everyone is aligned with the give and take and constant balancing. If not, you are setting yourself up for unhappy clients or frustrated staff. This will be the make or break of your anesthesia practice and you will be spending a lot of time managing this regardless of which side you want to support more than the other.

While staff utilization is one of the key metrics I use, there are several more that help to ensure financial success. I look forward to sharing those with you in future posts.