American Society of Regional Anesthesia and Pain Medicine February 2018 - 3

President's Message
Working for You: Practice Management
Resources Can Help You Be a Better
Provider
As professionals dedicated to improving patient outcomes, we
want to spend as much time as possible helping patients. But
more and more, we spend our time doing paperwork or electronic
administrative work.
Medical administrative costs in the United States significantly
exceed those in other developed nations. An article comparing
hospital administrative costs among eight developed nations
found that administrative costs in the United States exceeded
all others and accounted for 25% of total spending in United
States hospitals.1 A study by Casalino et al2 estimated that when
the amount of time spent interacting with insurance companies
was converted into dollars, the national time cost estimate to
practices was at least $23-$31 billion each year. It also estimated
that nursing staff spends an average of 13.1 hours per week on
authorizations.
As administrative costs have risen, physician reimbursement has
declined. In addition, physician compensation as a percentage of
health care cost in the United States is 8.4%, among the lowest
of major Western nations
compared to Germany's 15%
and France's 11%.

Committee is now charged with
developing the resource center
with a planned 2018 rollout.
In recent years, ASRA has
increasingly been allocating
resources toward practice
management. We provided
comments and feedback to the
Centers for Medicaid and Medicare
Services (CMS) regarding the
Merit-Based Incentive Payment
Asokumar Buvanendran, MD
System (MIPS) and Alternative
ASRA President
Payment Model Incentive under
the Physician Fee Schedule,
and Criteria for Physician-Focused Payment Models. We've also
created an educational curriculum at our annual meetings focused
on practice management issues. This past fall, we worked with
the American Society of Anesthesiologists to develop new quality
measures through the Acute and Chronic Pain Technical Expert
Panel. We are proud to say that CMS has approved the Anesthesia
Quality Institute (AQI) National Anesthesia Clinical Outcomes
Registry (NACOR) as a Qualified Registry and Qualified Clinical Data
Registry (QCDR) for 2018 MIPS reporting and has approved the
2018 menu of QCDR measures, posted here. ASRA members can
participate in AQI NACOR at
a discounted rate by going
to https://www.aqihq.org/
send-me-info.aspx

"Be sure to also take advantage of
the wealth of practice management
resources that we provide."

Physician burnout secondary
to practice management
challenges has also become a
major health care crisis. Multiple factors have been shown to drive
physician burnout,3 many of which are associated with practice
management. Linzer et al4-5 defined the primary factor associated
with physician satisfaction as the development of patient
relationships-independent of compensation.

All these statistics were part of a presentation made to the ASRA
Board of Directors by Board member David Provenzano, MD, during
its fall strategic planning session. Dr. Provenzano was requesting
funding for development of a full-service practice management
resource center, which would establish a portfolio that allowed for
continued and advanced learning through annual meetings, satellite
meetings, website material, newsletter articles, and webcasts. The
hope is that ASRA can help providers spend more time caring for
patients and less time struggling with administrative burdens. In
support of leaders with well-defined skills in practice management,
we hope to combat the trend toward physicians being detached,
with fewer resources available for the core missions of patient care,
research, and education. I am pleased to report that the project was
approved by the Board of Directors, and the Practice Management

ASRA will continue this
focus in 2018 with proposed
resources, including fact sheets on recommended quality measures
for MIPS, a checklist on how to earn 15 points to be neutral (the
minimum for 2018 is 15 points), and a "How I Do It" podcast on
implementing MACRA, focused on small- and medium-sized practices.
We are also very proud to report that ASRA has earned a seat on
the American Medical Association's Specialty and Service Society.
This allows ASRA to move one step closer to discussions about
current procedural terminology and related conversations.
Although you may often attend our meetings, read our publications,
or visit our website with the goal of learning the latest research
and developing your practical skills, be sure to also take advantage
of the wealth of practice management resources that we provide.
This aspect of your practice is becoming increasingly important
to ensure that you have the skills to be successful in practice and
ultimately provide the best care for your patients.
ACKNOWLEDGMENT
Thank you to David Provenzano, MD, for contributing to this article.

American Society of Regional Anesthesia and Pain Medicine
2018

3
https://www.aqihq.org/send-me-info.aspx https://www.aqihq.org/send-me-info.aspx
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