Anesthesia in 2012 – What to Expect

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With the first quarter of 2012 nearly complete, the key healthcare issues and trends that will impact anesthesiology this year are quite clear. And much like last year, the 2010 Patient Protection and Affordable Care Act will be a marquee concern.

The implementation of accountable care organizations (ACOs) could possibly lead to a lack of interest in the anesthesiologist profession. During a recent interview with Beckersasc.com, Dr. Adam Dorin, a practicing anesthesiologist, echoed this view. For an industry that’s already at the mercy of a staffing shortage, the hope is that Dr. Dorin’s premonition won’t come to fruition.

Another area of concern has been the significant drug shortage dilemma. An issue that has triggered action at the highest of levels,Dr. Dorin cites three factors that will continue to fuel this development: proliferation of lawsuits against pharmaceutical companies; the impact of drug patent terminations; and declining reimbursements for drug companies.

Marc Koch, MD, CEO of Somnia Anesthesia, shares Dr. Dorin’s view on staffing shortages and postulates that as an increasing number of patients are covered by Medicare and Medicaid, the cost for hospitals to maintain optimal anesthesia services could become exorbitant.

“The provider supply-and-demand kinetics has assaulted the hospital space,” said Dr. Koch. “Influenced by the migration of providers from the hospital space to the ASC and office-based venues, and magnified by the bottleneck of provider supply due to limited physician and CRNA training programs, the compensation for hospital anesthesiologists and CRNAs has skyrocketed.

“As if this was not bad enough, the current payer mix of hospitals is heavily weighted toward Medicare – and Medicare reimbursement for anesthesia is poor. The proposed component of healthcare reform that converts commercial patients to variants of Medicaid could prove to be the tipping point for hospitals already paying high subsidies to anesthesia groups to help cover their staffing costs.”

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