Becker's ASC Review

13 ASC MANAGEMENT A double-sided opportunity for anesthesia By Cameron Cortigiano T he ability to provide care and keep patients safe in newer, non- operating room settings is one of the biggest opportunities as well as hurdles for anesthesia providers, according to one physician. Taking the standard of care that has been established inside the operating room and moving it to new settings is an opportunity to expand anesthesia care, but also comes with its share of challenges. Stuart Bertsch, MD, who was recently appointed chair of the department of anesthesiology at the University of Cincinnati College of Medicine, recently connected with Becker's to share his view on the top challenges and opportunities for the industry. Note: is response was lightly edited for clarity and length. Question: What are some of the biggest opportunities and challenges facing the anesthesia industry? Dr. Stuart Bertsch: ey are all centered around a lot of the same aspects, whether you think of it as an opportunity or roadblock. One of them is really the non-operating room setting and how do you keep people safe. How do you take the standard care and the work that's being done throughout the operating rooms, which has been done for numerous years, and translate that to a newer location that most buildings in most areas are now trying to retrofit? You think about hospitals, except for the ones that are being built now, these areas were aerthoughts. How are you looking at your staff and equipment within these locations? It's a barrier in terms of the locale, the space, the availability of drugs and personnel that are not used to workflows. How you work with those individuals to standardize those aspects, is one of the biggest things that you'll see. at puts a big strain on the workforce as people feel less trained on moderate sedation or deep sedation from a procedural aspect. ey're more comfortable with an anesthesiologist or a nurse anesthetist being in the area and that's what they want. Also, I think that it's better for the patient when you talk about a quick deep sedation, that's quick onset, quick offset, and that they're going to be able to get them back to their preoperative state a lot faster. at's a huge demand that's put on the specialty right now, in terms of the number of cases that people want us to do. It's not being done in the same manner as your operating rooms. It's not the same level of scrutiny. It's important to work with health systems, leadership and your administrators, to focus on these areas. One way is to put metrics on them, to look at dashboards and utilization, and treat them just as you would for a normal operating room and procedural site, and then get them to buy into that same kind of culture, really, for the long term. ose are some of the things that the industry is really trying to overcome in terms of the barriers or the opportunity that we see every single day. n FTC drops noncompete ban appeal By Francesca Mathewes T he Federal Trade Commission has voted to dismiss its appeal in two legal challenges to its 2024 rule banning noncompete agreements. On Sept. 5, the agency dismissed appeals in Ryan, LLC v. FTC and Properties of the Villages v. FTC and acceded to the vacatur of the noncompete rule, which was struck down by a federal judge in Texas in August 2024. The rule would have invalidated millions of existing noncompete agreements and prevented employers from entering into or attempting to enforce and new noncompete agreements. FTC Chair Andrew Ferguson and Commissioner Melissa Holyoak, who both dissented when the rule was first issued, said the agency had lacked the authority to issue the rule, noting it would have preempted state laws, voided more than 30 million contracts and redistributed "nearly a half trillion dollars of wealth within the general economy." While the FTC's rule will not take effect, Mr. Ferguson said the commission under current leadership will continue to pursue enforcement actions against what it views as unlawful noncompete agreements through antitrust laws. n CMS targets ASC procedures for prior authorization pilot By Patsy Newitt O n Dec. 15, CMS will launch a five-year prior authorization demonstration for certain ASC services in California, Florida, Texas, Arizona, Ohio, Tennessee, Pennsylvania, Maryland, Georgia and New York. According to a Sept. 3 CMS notice, the targeted procedure categories include: • Blepharoplasty • Botulinum toxin injections • Panniculectomy • Rhinoplasty • Vein ablation procedures ASCs may begin submitting prior authorization requests on Dec. 1, 2025, for dates of service on or after the Dec. 15 start date. The CMS notice clarified that prior authorization is voluntary under the demonstration. However, facilities that choose not to participate will have applicable ASC claims subject to prepayment medical review. n

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