A new anesthesia model for ASCs

ASCs continue to face significant challenges securing anesthesia providers due to declining reimbursements and growing shortages. Many centers are being forced to rethink their anesthesia models as competition increases, making it harder to retain anesthesiologists.

As reimbursements rapidly decline, some ASCs are being asked by their contracted anesthesia groups for a stipend — a minimum daily payment — to ensure anesthesiologists are fairly compensated and anesthesia groups maintain a reasonable profit margin.

Bruce Feldman, administrator of Eastern Orange Ambulatory Surgery Center in Cornwall, N.Y., is introducing a new approach to anesthesia stipends. His center plans to have surgeons pay a fee if they don’t meet the minimum number of cases required for their assigned block of operating time.

“Let’s say a surgeon’s block requires a minimum of eight cases, but they only end up doing six cases,” he told Becker’s. “The anesthesia group will send a bill to the surgeon for $300 for each case that they were short, resulting in a bill of $600 in this scenario. So the financial hit will fall on the surgeon, not the center.”

Although he anticipates some resistance from surgeons, Feldman believes this model will “ensure that surgeons fulfill their blocks and prevent the operating room from sitting idle.”

“We could not financially afford to pay our anesthesia group a stipend of $2,000 to $3,000 a day,” he said. “It’s a win-win scenario for both the center and the anesthesia group … I think this is a unique model that we’re going to implement.”

Feldman and his leadership team are launching the program as a three-month pilot and will reassess it at the end of the trial period.

“I’m sure there will be some initial pushback, but the alternative is that they won’t have anesthesia coverage,” he said. “The goal is that there won’t be any feedback, as the surgeons will realize they’ll incur a financial hit if they don’t maximize their block … We’re trying to create an incentive for them to fulfill their block rather than create an additional financial disincentive for surgeons.”