Becker's ASC Review

36 ANESTHESIA Financial opportunities in anesthesia flat-fee services By Patsy Newitt T he American Society of Anesthesiologists' 2020 update of its Relative Value Guide has new updates that affect the way flat-fee services are billed. A blog post by Tony Mira, founder of MiraMed's Anesthesia Business Consultants, detailed a potential financial opportunity in these changes. Non-time-based services, like flat fees and some obstetric anesthesia services, are paid on a fee schedule. Nerve blocks, a non-time-based service, have seen a dramatic increase in numbers performed in the past few years, which has resulted in a significant increase in revenue for some anesthesia practices. e diversity of rates in flat-fee services, which Mr. Mira outlined in his post, comes from practitioners not performing many nerve blocks for acute pain management. e ASA has changed the way flat-fee services are billed, Mr. Mira said, which is a reflection of how a majority of anesthesia contracts with payers specify an anesthesia unit rate. But increasingly, flat-fee services default to some percentage of Medicare rates. Anesthesia practices oen neglect to request reasonable payment for their flat-fee service, and this request could be a revenue opportunity — especially if they perform blocks routinely. Flat-fee services, such as nerve blocks, represent additional financial benefit on existing surgical volume, Mr. Mira said. Taking full finan- cial advantage of the opportunity requires that the practice's contract- ing strategy takes them into consideration to negotiate reasonable fee schedules. n FDA approves Exparel anesthetic for children: 4 details By Laura Dyrda T he Food and Drug Administration approved Pacira's supplemental new drug application to expand the use of its long-acting local anesthetic, Exparel, in children. Four details: 1. Pacira's bupivacaine liposome injectable suspension prod- uct is used in a variety of procedures, including orthopedic and spine surgeries. 2. The FDA approved Exparel for adults in 2011 and now will allow surgeons to use the product for pediatric patients ages 6 years and older. 3. Exparel is the first long-acting local anesthetic approved for pediatric use. The approval is based on a phase 3 study of Exparel in pediatric patients undergoing spine and cardiac procedures, which found no safety concerns. 4. More than 8 million patients have received Exparel for nonopioid pain control. n What NorthStar Anesthesia did so far in 2021 By Carly Behm I rving, Texas-based NorthStar Anesthesia kicked off the year completing its expansion to serve seven facilities in Michigan. The company is continuing that momentum, growing its footprint in four other states so far in 2021. Three notes this year: 1. The company completed its transition to provide services at seven facilities with Southfield, Mich.-based Beaumont Health. 2. NorthStar landed a new client with Baptist Health Hardin in Elizabethtown, Ky. Most of the incumbent group's anesthesiologists were recruited to NorthStar in the move. 3. NorthStar expanded to serve three hospitals: Wilm- ington, Del.-based Saint Francis Healthcare, a member of Trinity Health System; the Great Falls (Mont.) Clinic; and Lubbock (Texas) Heart and Surgical Hospital. n

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