The Centers for Medicare & Medicaid Services (CMS) received bipartisan support for accelerating a transition from traditional fee-for-service to performance-based health care payments that link compensation to quality outcomes. Given the significance of perioperative services to a hospital's financial performance, this transition to value-based payments has profound clinical and business implications for the practice of anesthesiology. Anesthesiologists must ask two fundamental questions:
Co-management agreements (Figure), hospital quality and efficiency programs (HQEPs), and clinically integrated networks (CIN) are three examples of organizational relationships that allow anesthesia groups to collaborate with perioperative stakeholders and health systems on shared goals. Co-management agreements do not require a high level of integration but do allow anesthesia groups to collaborate with health systems on achieving common goals. Compensation can consist of fixed payments for the time spent on administrative functions and variable payments based on achievement of predetermined quality or efficiency objectives, usually with...
