Economics & Payment
Enhance the value of your anesthesia practice and protect your payments for services provided.
The economic health and viability of your practice is a fundamental priority for ASA.
Health care’s economic environment has never been straightforward — consider the creation of third-party payers and the implementation of the Medicare program. Further challenges were introduced with changes to payment systems that transitioned from payments based on Usual, Customary and Reasonable (UCR) charges to the Resource-based Relative Value System (RBRVS) which created the 33% problem for anesthesiology. The environment has become increasingly complex in recent years with a shift from Fee for Service (FFS) to value-based payments.
It is vitally important for anesthesiologists to understand how they are paid, and can identify the factors influencing payment, to maximize their value to ensure fair and appropriate payment. ASA continues to prioritize efforts to support its members and their economic viability through the Economic Strategic Plan Initiative (ESPI). As part of this initiative, we curated a compendium of relevant ASA Monitor® articles to help further understanding and insights about the issues. These articles cover a wide range of topics and include both background information and practical guidance on how an anesthesia practice can enhance its value and protect and improve its payments for services provided. This collection provides a big-picture view of ASA’s previous work, accomplishments, and ongoing efforts — for the benefit of anesthesiologists.
In addition, Tom Miller’s column, The Curious Economist, offers a broader perspective of the health care economic environment, provides information that will strengthen and expand your knowledge, and help you navigate these complex challenges.
We hope you will find this compendium informative and useful.
Curated by Jeffrey T. Mueller, MD, FASA, ASA Vice President for Professional Affairs
33% Problem |
ASA Commercial Conversion Factor Survey Results – 2023November 2023 Get Up, Stand Up – for a United ASAJuly 2023 A Financial Model of the 100% Medicare PracticeJune 2023 The 33% Problem: A Discussion With Hospital ExecutivesOctober 2022 Medicare Payment from MACRO and MICRO PerspectivesAugust 2021 Payment Progress Series, Part 4: Committee Projects and Member EmpowermentAugust 2021 Perfect Storm…or Perfect Opportunity?August 2021 Payment Progress Series, Part 3: Abusive Insurer Negotiation TechniquesJuly 2021 The 33% Problem: Why It Matters and What We Can Do About ItMay 2021 The 33% Problem: Origins and Actions Committee on Economics 33% Workgroup Report ASA Economic Strategic Plan Initiative—October 2020December 2020 Meeting the Challenges of Future Payment SystemsJuly 2019 |
Coding |
Cigna Policy Change on Modifier QZ PaymentApril 2023 2023 Payment Changes for Anesthesia and Pain ServicesFebruary 2023 Show Me (More) Than the Money! What You Need from Your Billing Partner in 2022 and BeyondMay 2022 Medicare Payment from MACRO and MICRO PerspectivesAugust 2021 Perfect Storm…or Perfect Opportunity?August 2021 HHS/CMS Ongoing Efforts to Reduce Improper Medicare PaymentsFebruary 2021 Patient Relationship Modifiers and 2020 MIPSFebruary 2020 Coding Update for 2020December 2019 Speaking the Same Language: Why Understanding E/M Services Is Important to AnesthesiologistsAugust 2018 Potentially Misvalued CodesFebruary 2018 |
Commercial fees research |
ASA Commercial Conversion Factor Survey Results – 2023November 2023 Commercial Fees Paid for Anesthesia Services – 2022October 2022 Prepare to Participate in the 2022 Commercial Conversion Factor SurveyApril 2022 Physical Status and Qualifying CircumstancesDecember 2021 ASA Survey Results: Commercial Fees Paid for Anesthesia Services – 2021October 2021 Payment Progress Series, Part 3: Abusive Insurer Negotiation TechniquesJuly 2021 ASA Survey Results for Commercial Fees Paid for Anesthesia Services - 2020October 2020 ASA Survey Results for Commercial Fees Paid for Anesthesia Services - 2019October 2019 ASA Survey Results for Commercial Fees Paid for Anesthesia Services - 2018October 2018 |
Cost of education and training |
Resident Compensation – Who Funds Us and What Is Our Value?October 2023 Is It Worthwhile to Do a Fellowship After Residency?September 2023 Finding Residency Positions for Americans Who Train AbroadSeptember 2023 2023 Residency Match: Anesthesiology Is One of the Most Competitive SpecialtiesAugust 2023 Market Concentration in Health CareJune 2021 Assessing ROI in Education and TrainingApril 2021 The Economic Barriers to Becoming an AnesthesiologistJuly 2020 |
Covid economic relief |
Covid’s Economic Impact on Your Practices: 2020, 2021 and BeyondJune 2020 |
practice management considerations |
Medicaid: Safety Net or Medical Albatross?December 2023 Be the Solution: How Anesthesiologists Offer Short- and Long-Term Solutions to Workforce ChallengesNovember 2023 Drug Shortages: How ASA Is Helping Members Navigate an Uncertain Road AheadNovember 2023 Resident Compensation – Who Funds Us and What Is Our Value?October 2023 ASA-AHA Partnership to Promote the Value of Anesthesiologists to Health Care ExecutivesSeptember 2023 Payer for Administration, Education, and Innovation in AnesthesiologyMay 2023 The Revenue Sky Is Falling – Are Hospitals the Safety Net?April 2023 supplement Geographic Monopolization of Physician Practices and Health Care Systems: Implications for AnesthesiologyApril 2023 supplement How Business Will Disrupt Health CareApril 2023 supplement Create Your Value Proposition Before You Need ItJanuary 2023 Hospitals Under Pressure: Showcase How Anesthesiologists Control Costs and Maximize Financial HealthDecember 2022 Responses to 2 Workforce Questions from Curious ReadersNovember 2022 The Trillion Dollar Six-Pack of Publicly Traded Health Insurance CompaniesMay 2022 Show Me (More) Than the Money! What You Need from Your Billing Partner in 2022 and BeyondMay 2022 Not So Easy: Cost Analysis of Staffing Models of Anesthesia CareMay 2022 The Anesthesia ‘Employed’ Model: Is This Our Destiny?May 2022 ASA Survey Results: Commercial Fees Paid for Anesthesia Services – 2021October 2021 Anesthesia Practice Finances, 2030October 2021 Market Concentration in Health CareJune 2021 Roundtable with ASA’s Payment and Practice Management Physician LeadersApril 2021 Understanding Your Billing and Financial Data: Maximizing the Physician/Administrator TeamJanuary 2020 Review the Past and Prepare for the FutureDecember 2018 |
Regulatory updates, evaluation and management |
Tracking Intraoperative Hypotension: A Measure for Payment and Improvement PurposesJanuary 2024 Medicaid: Safety Net or Medical Albatross?December 2023 Drug Shortages: How ASA Is Helping Members Navigate an Uncertain Road AheadNovember 2023 Interoperability: A Rising Health IT Priority for ASA and Federal RegulatorsSeptember 2023 How the No Surprises Act Privileges Insurance Companies Over Anesthesiologists – And What ASA Is Doing About ItFebruary 2023 Summer 2022 Regulatory Affairs and Quality Measure UpdateSeptember 2022
Summer 2022 Regulatory Affairs and Quality Measure UpdateSeptember 2022 The Implications of Health Care ReformJune 2021 Trends in Commercial Health Insurance and Implications for AnesthesiologyMay 2021 HHS/CMS Ongoing Efforts to Reduce Improper Medicare PaymentsFebruary 2021 2021: Through a Cloudy Crystal BallDecember 2020 Office/Outpatient Evaluation and Management: Changes AheadAugust 2020 Already Looking to 2021April 2020 Meeting the Challenges of Future Payment SystemsJuly 2019 2019: Unanswered Questions RemainFebruary 2019 Speaking the Same Language: Why Understanding E/M Services Is Important to AnesthesiologistsAugust 2018 June ProposalsJune 2018 2018: A Busy YearApril 2018 |
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