Blue Dog Democrats Raise Concerns for Healthcare Reform
The Blue Dog Coalition, a group of fiscally conservative House democrats, has submitted a letter to Speaker Nancy Pelosi and Majority Leader Steny Hoyer outlining a number of concerns about the Tri-Committee draft health reform bill. American Society of Anesthesiologists (ASA) strongly supports the Blue Dog Coalition’s concerns about a public plan option based on Medicare payment rates.
ASA President Roger A. Moore, M.D., has released the following statement in response to the Blue Dog Coalition’s letter: “On behalf of ASA’s 43,000 physician members, I applaud the Blue Dog Coalition members and leadership for opposing a public plan option based on Medicare rates, and for recognizing that a Medicare-like public option would negatively impact doctors and patients. Further, I am pleased that the Coalition maintains that physicians and other health care providers should be able to voluntarily participate in the program, rather than being mandated by Congress.
“We are working together on one of the most comprehensive health care reform efforts this government has ever undertaken. We commend the “Tri-Committee” members and staff for their efforts toward meaningful and effective delivery reform. However, we believe that as part of responsible reform, we must ensure that a public plan option fairly compensate physicians for their services. As it stands, Medicare pays anesthesiologists 33 percent of what private insurers pay—a rate that simply does not cover the costs of providing anesthesiology medical care. An expansion of this inadequate payment system as proposed by the “Tri-Committee” would not be sustainable for private practice and academic anesthesiologists.
Anesthesia Practices Weigh Options for a Pain Center
Opening a pain management facility can generate additional income for your anesthesiology practice, but it can demand a lot of time and overhead. When deciding whether to venture into pain management, look beyond potential revenue. Instead, view it in the context of risk, time required to get it up and running, and the myriad regulations governing what you can do. Listed below is a process for evaluating the many issues related to opening a pain management facility.
A Process for Success:
- Determine whether you want an office-based or ambulatory surgery center (ASC)-based facility. Each has benefits and drawbacks.
- Check your state regulations. Many states have jurisdiction over what procedures office-based facilities can perform. The facilities may need to meet state licensing, registration and/or accreditation requirements to perform certain kinds of procedures or those demanding certain levels of anesthesia.
- Consult with commercial payers in your area to arrive at their requirements for a physician(s) to receive certification to function as pain specialists in the office-based settings.
- Determine the provisions for state licensure and the Medicare conditions of participation for ASC certification.
- Assess the catchment area for competition.
- Understand the Certificate-of-need requirements (and possible exemptions in certain situations), as well as other state requirements.
- Evaluate the return on investment of your pain center in multiple locations (office based, ASC and hospital).
- Create a detailed business plan that outlines the projected revenues by procedure type, volumes anticipated and payer mix.
- Create a marketing plan with referral sources and projected referral patterns by specialty.
- Create your staffing model based on anticipated procedure volumes and staff mix.
- Create an operating cost budget to compare against the revenue assumptions to determine the break-even period.
- Determine the pain management and regional anesthesia capabilities of each physician partner and determine the training needs to implement your pain service.
- Draft a communication plan to cast a common vision for the anesthesia partners so that everyone is on the same page and understands the benefits for expanding into the pain management arena.
- Implement your plan and monitor the progress.
- Celebrate your successes.
Just as with any new business venture, the better the research, business plan and implementation, the better chance of success. To successfully launch your new pain management facility, keep it simple and realistic. The payoff can be big, but only if you do it correctly.
