Anesthesia Services: Addressing the Financial Challenges

Episode Overview

As healthcare providers grapple with the shortage of anesthesia providers and increasing financial constraints, leaders are redefining their relationships with anesthesia providers. In this episode of Value-Based Care Insights, Daniel Marino is joined by Tim Hanners and Dr. Dave Lebec where they address these challenges and explore best practice approaches in working with employed and independent anesthesia groups. The discussion explores ways to improve financial performance by enhancing anesthesia outcomes, optimizing staffing models, and managing reimbursement from payers.

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Host:


Daniel J. Marino

Managing Partner, Lumina Health Partners


Guests:

Tim Hanners

Managing Principal, Lumina Health Partners

Dr. Dave Lebec

Chief Medical Officer, Physician Executive, Medical Director

Daniel Marino:

Welcome to value based care insights. I am your host, Daniel Marino. In today's topic, we're going to spend some time talking about the changing anesthesia market and a lot of the pressures that we're seeing from our industry. Either. As a result of the anesthesia activities that are occurring. Maybe the shortage of the anesthesiologists and the sees of providers that are across the country, as well as the economic pressures. In many hospitals surgical services remains, if not the largest generator of revenue, It's certainly number 2. And yet anesthesia is such a critical component to providing that level of surgical services, not just in the hospital, but also in the surgery centers. So many hospitals are actually expanding their surgical services combining the services in the acute arena, but also in the ambulatory area.

Well, I'm really excited today to have 2 wonderful guests, 2 great colleagues, Tim Hanners, who is a former hospital executive, and has been working in the anesthesia space for a number of years, has helped, you know, quite a few organizations around the country help to improve and work through a lot of their anesthesia economic challenges as well as a lot of the operational challenges. I also have Dr. Dave Lebec and Dr. Lebec has been the chief medical officer for nationally, and the Seizure Service Company. Again, has worked with numerous organizations around the country from the provider perspective, just really helping to align the incentives and create a lot of clinical as well as operational efficiencies. Tim, Dave, welcome to the program.

 

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The Effect of Private Equity Interests on Healthcare Providers

Episode Overview

With private equity's growing influence in healthcare systems, the significance of aligning healthcare providers has never been greater. In this episode of Value-Based Care Insights, we delve into the complexities of private equity interests and their profound impact on healthcare providers. Join Ericka Adler, a seasoned attorney at Roetzel & Andress, as she explores the current trends in private equity and their implications on physicians and healthcare systems. Gain insights into physician employment models, the regulatory landscape, and effective strategies for healthcare transactions.

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Strengthening Payer-Provider Partnerships in Medicare Advantage Plans

Episode Overview

As Medicare Advantage enrollment rises and traditional Medicare enrollment declines, collaboration between payers and providers becomes essential. However, these relationships have historically been fraught with challenges and various administrative complexities. In this episode of Value-Based Care Insights, we explore the critical need for effective payer-provider partnerships with SueEllen Carroll, Managing Director at AArete, and Darren Ghanayem, a seasoned expert in healthcare and IT. SueEllen and Darren join us to share their insights on building trust between payers and providers, along with strategies for improving governance. Gain insights into fostering payer-provider contract collaboration, improving patient care, and reducing the administrative burden often associated with Medicare Advantage contracts.

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Leveraging Data to Guide Discussions on Provider-Payer Contracts

Episode Overview

As healthcare providers engage in payer contract negotiations, understanding their contractual reimbursement rates compared to the market has never been more crucial. In this episode of Value-Based Care Insights, we sit down with Damon Morse, an expert in payer rate analyses, to discuss the challenges healthcare providers face with payer contract negotiations, and the strategies required to level discussions. Gain insights into how thorough analysis and strategic positioning can ensure fair reimbursement for provider organizations and support organizational growth.

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The Provider’s Playbook for Medicare Advantage Plans

Episode Overview

Medicare Advantage has been the subject of significant attention lately among provider organizations due to its distinctive demands that influence traditional practice operations norms. In this episode of Value-Based Care Insights, we sit down with Sarah Hartley, an expert in health information management, to discuss some of the hurdles with new Medicare Advantage contracts, along with the efforts needed to align providers and patients. Gain insights into the administrative challenges, diverse strategies for effective patient data management, and the essential cultural shift required to promote collaboration between provider organizations and payers.

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Building an Integrated Ambulatory Network: Forty-Five Years of Medical Group Strategy

Episode Overview

Forty-five years after a Chicago hospital pioneered an integrated network strategy, the healthcare landscape has undergone a significant shift towards prioritizing preventative care. In this episode of Value-Based Care Insights, Jeffry Peters, an expert on medical group strategy, along with Michael Antoniades, President of the University of Chicago Medicine, explore the groundbreaking challenges and strategies that revolutionized healthcare delivery, and how they are still being tackled today. Gain insights on the evolving focus towards preventative care, the measures used to evaluate healthcare delivery, and the pivotal role of primary care in bolstering the entire healthcare ecosystem.

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A Physician Leader’s Journey: Strengthening Culture as a Catalyst for Growthv

Episode Overview

Within the healthcare industry, effective organizational culture requires building trust, nurturing collaboration, and positioning leaders to drive strategic and impactful change. In this episode of Value-Based Care Insights, we sit down with Dr. Eric Velazquez, Professor of Medicine at Yale, alongside Doug McKinley, a clinical psychologist and leadership coach. Together, they explore the challenges and opportunities of strengthening the workplace culture in order to improve organizational effectiveness, financial performance, and overall patient care. Gain insights on the importance of vision alignment, a healthy culture, team collaboration, and the delicate balance between “steering the ship” and delegating responsibility.

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Unraveling the Impact of Behavioral Health on Patient-Centric Care

Episode Overview

Behavioral health is pivotal for overall patient well-being, yet healthcare providers are just beginning to recognize the significance of lifestyle factors and social determinants in delivering this sort of whole-person patient-centric care. In this episode of Value-Based Care Insights, host Dan Marino sits down with Dr. Matthew Burg, a clinical health psychologist at Yale, to explore how social determinants and behavioral medicine are addressing the clinical needs of patients. Gain insights into the challenges and opportunities involved in integrating behavioral health into patient care, in prioritizing quality outcomes over services, and in recognizing the importance of preventative measures to establish a more comprehensive patient-centric care delivery system.  

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Designing Prospective Care Management Models for Optimal Patient Outcomes

Episode Overview

Effective care management is essential for achieving favorable population health outcomes. Yet, the current structure of care management focuses on reacting to health issues and does not adequately anticipate patients' needs. As providers assume risk-based contracts, the shift to prospective care management allows care managers to more effectively meet the patient’s needs by integrating clinical data, lifestyle criteria, and clinical pathways.
 
In this episode of Value-Based Care Insights, I sit down with Dr. Riya Pulicharam and Kevin Zhao, as they delve into the limitations of the current care management model and discuss attributes essential to support enhanced patients outcomes while increasing the productivity of the care managers. Gain valuable insights into how to optimize care pathways, leverage technology, and foster cultural change to ultimately achieve better outcomes. 

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Technology Trends and Patient Benefits: Health Technology Assessments with Dr. Jason Spangler

Episode Overview

Improving patient outcomes requires a close look at the latest innovations in healthcare. In this episode of Value-Based Care Insights, we sit down with Dr. Jason Spangler, CEO of the Innovation and Value Initiative, a non-profit organization focused on advancing the science of determining the merit of various clinical innovations. Dr. Spangler sheds light on health technology assessments (HTAs), their history, and how they help leaders decide which new technologies or devices provide interventional benefits to patients that includes clinical outcomes and cost analysis. Listen to gain insights into how HTAs consider clinical outcomes, the incorporation of health equity, and how social determinants provide a broader understanding of the benefits that shape healthcare decisions. 

KEY TAKEAWAYS:
  • A health technology assessment (HTA) is a comprehensive analysis that evaluates the cost-effectiveness and clinical and societal impact of new healthcare technologies and innovations.  
  • HTAs have to take into consideration many different kinds of value, from traditional quantitative clinical outcomes to more nuanced preventative measures and patients’ personal values.
  • Technology plays a significant role in shaping the efficiency and cost dynamics of population health, with various assessments offering healthcare leaders deeper insights into where the benefits lie.  

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