4 Reasons Why: Moving Procedures in-Office.

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Reason #1: ADVANCES IN ANESTHESIA AND SURGICAL PROCEDURES

The modernization of anesthesia, particularly outsourced anesthesia, has played a clear role in the site of service transition to office-based procedures.

The healthcare industry is undergoing a dramatic transformation. The past decade has seen a steady increase in surgical procedures moving away from hospital environments into surgery centers. While surgical centers are exploding as health systems and hospitals rush to expand their footprint in ASCs, the healthcare industry is experiencing another shift as more procedures move to physician offices. Advances in technology and medicine, patient preferences, and financial incentives for both physicians and insurance payers are driving this site of service transformation.

Physicians are choosing their offices to perform procedures instead of the hospital or ASC to regain control over their schedules. Work-life balance improves with performing procedures in one’s office. Physicians appreciate a more efficient, streamlined calendar with no additional travel required. Generational preferences also contribute to this shift.

This is a very exciting time for physicians. However, it’s important that things are done correctly and methodically so quality of care and patient safety are never compromised. Attempting to take on more than a practice is capable of, or cutting corners are things that must be avoided at all cost.

The decision to perform procedures in-office must not be taken lightly. Education is the key to understanding what is required to create a safe surgical environment. Personnel, resources, anesthesia, and emergency preparedness are just some of the requirements physicians must familiarize themselves with. This knowledge will help determine whether the move from a hospital and/or surgery center to an office-based setting is the right choice for a practice.

There are key drivers of the site of service shift, as well as the risks and rewards associated with moving procedures out of a hospital and/or surgery center and into an office-based setting. There is also a unique opportunity for physicians, insurance companies, and any outsourced anesthesia partner to drive quality and success for everyone involved, especially patients. Let’s get into how.

Anesthesia has evolved significantly over the years and its impact has revolutionized the surgical process. Anesthetics like Propofol and Ketamine have minimized common side effects such as hallucinations, nausea, and vomiting which were known to last for hours, even days. Today’s quick-acting, quick-recovery anesthetics significantly speed up the sedation process greatly minimizing the time patients spend in intra-op. Patients fall asleep, wake up, and recover more quickly without complications. More importantly, today’s anesthetics are much safer than their predecessors. For example, unlike oral opioid-based anesthetics, which are agents that were frequently used in the past, there are little to no additional concerns with anesthetics like Propofol.

New monitoring technologies further contribute to a much safer experience by enabling continuous monitoring of vital signs such as blood pressure, oxygen levels, heart rate, brain activity, and breathing patterns. Previously, otherwise simple procedures such as endoscopy or colonoscopy were limited to hospitals and surgery centers because of safety concerns and the lengthy recovery typical of earlier anesthetics. Now, thanks to anesthetics like Propofol and conscious sedation elements, procedures like hysteroscopies and vascular stent placements are just that, simple, making them safe for office-based settings. While these advances have helped clear the way for less invasive procedures to move to office-based settings, additional roadblocks existed. Unlike hospitals and surgery centers, physician offices weren’t equipped with the personnel, resources, and certifications required to use anesthesia. And because physicians were accustomed to simply showing up at a hospital or surgery center where everything was readily available, most had no idea how to begin preparing for office-based use of anesthesia. Outsourced anesthesia services have become an increasingly popular solution to this problem.

From a financial perspective, a turn-key outsourced anesthesia partner assists in direct cost savings along with reduced clinical and administrative resources. An outsourced partner eliminates the need to recruit and pay for ACLS-certified pre-op and recovery nurses. And, some outsourced anesthesia companies will even go so far as to provide anesthesia-related supplies, equipment, medications, and emergency preparedness. This means that everything a physician office would need related to anesthesia is taken care of in advance so when anesthesia partners arrive they can focus on their core strength, treating patients. The modernization of anesthesia has played a clear role in the site of service transition to office-based procedures. Recognizing these advances, more and more payers are expanding their list of covered procedures to their health insurance plans. Within the past five years, annually 8-12 procedures have been approved for higher reimbursement in the office. And this list will continue to grow. In fact, Medicare and other carriers have greenlit dozens more reimbursement incentives for the office setting that will be effective in the next 12-24 months. 

Want to learn more? The entire four part series is available below. They can be read based exclusively on your interest in the topics, or in sequence.

4 Reasons Why Part II: The Evolution of Office Healthcare Technology

4 Reasons Why Part III: Changing Industry and Demographics

4 Reasons Why Part IV: Improved Physician Reimbursement