There is no way to begin talking about the future of anesthesiology without first ripping off the Band-Aid and recognizing that the nice, safe harbor of our operating rooms is no longer our nice safe harbor. During the past few decades we have been compelled to focus on our work within the four walls of the O.R. because this is how we get paid for the majority of the anesthesia services we perform. But how we get paid is changing, which, in turn, will transform how we practice. Without a multidisciplinary approach and cohesive integration of the services we provide with the other services involved in each patient care episode, we will not be able to accomplish the requirements of the new payment models implemented in the Medicare Access and CHIP Reauthorization Act (MACRA).

Although the focus is reported to be the patient, the Centers for Medicare & Medicaid Services...

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