Anesthesiologists mean business

Andrew B. Leibowitz, MD

Andrew B. Leibowitz, MD

Being a successful anesthesiologist goes beyond just being a good doctor. It’s also about being good at business.

The ability to follow and even predict business trends, keep up with the compensation structures for various care team models, and analyze billing metrics to optimize financial outcomes represent a fraction of the business acumen anesthesiologists must possess to be successful in their practice.

Andrew B. Leibowitz, MD, Professor and System Chair of Anesthesiology, Perioperative and Pain Medicine at the Icahn School of Medicine at Mount Sinai in New York City, will offer a comprehensive review of these topics as well as Medicare and Medicaid spending and reimbursements during today’s session “The Business of Anesthesiology Update.”

One trend important for anesthesiologists to recognize is the doctor versus CRNA compensation structure and its impact on the cost of a care team model, said Dr. Leibowitz.

The Business of Anesthesiology Update

2-3 p.m. CT
Saturday, October 3

“Most anesthesiologists are unaware that employing CRNAs is much more costly than employing doctors, especially when supervised in less than, or sometime even equal to a 1:3 ratio,” he said. “Nationally, CRNA total compensation is equal to or greater than half that of a doctor’s compensation and CRNAs typically work fewer hours, do much less night and weekend call, and oftentimes have better and more costly benefits than doctors.”

Anesthesiologists must also be aware of Medicare and Medicaid spending and reimbursements. Medicaid alone covers more than 70 million Americans, which represents about 23% of the entire U.S. population, said Dr. Leibowitz.

Additionally, Medicare and Medicaid combined make up nearly 20% of the U.S. federal budget, which this year is on track to exceed a deficit of $3.5 trillion.

“In most states, Medicaid pays very poorly,” Dr. Leibowitz said. For example, in New York, Medicaid uses approximately a $10 conversion factor, resulting in a reimbursement of about $60 per hour of care. And these reimbursements are only going to get worse, he said. “In 2021, Medicare is on track to slash anesthesiologist reimbursement by 10%.”

Another business consideration for anesthesiologists is whether to participate in bundled or capitated payments, which come in several varieties.

“Anesthesiologists need to know if the bundle they are participating in will pay them their usual fee for service, a fixed fee for service and whether they have an upside and/or downside risk,” Dr. Leibowitz said.

“This session will go beyond the basics of first-case start time and utilization to address justifying a subsidy based upon payer mix, OR utilization including relative value unit (RVU) productivity per doctor and per room, non-OR anesthesia (NORA), and call responsibilities,” he added.

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