MMP’s depth of expertise greatly benefits our clients, and we would like to share with you some of that industry knowledge in the white papers listed below.

There are many buzz words floating around the medical billing community – “transparency” being no exception. But while it may seem that the term is self-explanatory, its meaning suggests that every participant in the billing cycle is allowed to see what is going on – from large-scale strategies to tiny details. On a large scale, a practice might consider total cash flow in a given time period, the status of claims, and quality measures. From a smaller standpoint, a practice might wonder about individual claims: their creation, history, validity, corrections, submissions, and reconciliation until payment, in order to understand the big picture.
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As anesthesia providers move away from a traditional business model outside of the hospital setting, they must consider how to strategically plan for revenue increase that will impact the survival of their practice as they work with other specialties on in-office procedures. The bond between anesthesiologists and hospitals has been slowly diminishing while more cost efficient outpatient surgery centers become more appealing to patients. It is not a new idea that anesthesiology practices take a nomadic approach and work outside of the hospital, but as it becomes common practice, anesthesiologists must differentiate their business in a competitive field.
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Most stipend arrangements have components in their calculation that deal with physician compensation, which gives rise to one of the major causes of friction among anesthesia practices and facility administrators.

It is first important to address the use of the word “stipend” in relation to “cost share” for the purposes of this paper. The first four synonyms in a word search for stipend are salary, pay, earnings and income. Cost share arrangements are often referred to as stipends because administrators perceive the word to be synonymous with anesthesiologists’ pay. In a surprising number of occasions, the actual reason for a stipend has little or nothing to do with anesthesiologists’ compensation. For that reason, cost share seems more appropriate, less aversive and is how it will be addressed.
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It is important that managed care contracts be closely scrutinized from many angles to assure anesthesia practices are getting the proper reimbursement. Many savvy practice leaders and physicians understand that complex language within a managed care contract requires strict attention to assure reimbursement is met in follow through of what is stipulated. However, many facets of managed care contracts outside of the language can be overlooked and therefore directly affect a practice’s reimbursement. This paper will address both complex contract language and negotiation tactics that can directly and positively impact reimbursement.
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Subsidies or stipends must be beneficial for anesthesia practices and hospitals in order for both to maintain financial stability in an environment marked by shrinking reimbursements, growing competition and rising costs.

Among the major medical specialties, anesthesiology has long represented a relatively small percentage of total healthcare costs and thus generally has not been the target of aggressive payor scrutiny or audits.

But that will likely change as the government's new Medicare audit initiatives gain traction. Chief among these programs is the Recovery Audit Contractors Program (RACs), a nationwide effort that relies on independent contractors to ferret out improper provider payments in exchange for a percentage of the dollars recovered.
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With reimbursement pressures continuing to grow, ensuring that anesthesia groups collect every dollar they are entitled to has never been more important. Fortunately, this task is made easier if anesthesia groups take steps to reduce or eliminate common documentation and coding mistakes.

Reducing errors requires a detailed, up-to-date understanding of anesthesia coding, a working knowledge of anatomy and open channels of communication between coders and physicians. A process that allows coders to follow-up with physicians on specific case questions and also offers real-time feedback regarding incomplete or inaccurate documentation can go a long way toward strengthening the anesthesia revenue cycle.
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The Physician Quality Reporting Initiative (PQRI), Medicare's two-year-old, quality-reporting program, continues to evolve for 2009 with the inclusion of two additional quality measures for anesthesia providers and an increase in the bonus paid to participating physicians from 1.5 percent to 2 percent.

PQRI was officially launched in 2007 as one of several quality reporting programs developed by the Centers for Medicare & Medicaid Services. The program reflects CMS' goal of gradually shifting the Medicare program toward a greater emphasis on pay-for-performance. Although involvement in PQRI currently is voluntary, most observers expect that participation eventually will become mandatory for Medicare providers.
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By examining current staffing patterns and volume, anesthesia groups should be able to develop staffing models that meet hospital requirements more efficiently. Once these options are identified, groups should next focus on the hospital side of the equation to pinpoint areas where hospital scheduling may be creating undue financial hardship for the group. An OR efficiency study that examines OR utilization by hours-of-the-day frequently will reveal areas ripe for streamlining.
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Physician groups often find it difficult to carve out time for long-term strategic planning amid the relentless demands and frequent turbulence of day-to-day operations. Yet stepping back to develop solid business objectives has never been more important for medical groups.
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