Here are the factors an anesthesia group weighs when considering a
contract's worth at your facility.
Your payer mix. You might assume all lap choles pay the same.
They don't. Nor can you assume that complex procedures
involving very sick patients always pay more. Medicare pays much
less than commercial insurance. A typical 10-unit case for a private
payer might pay $500 ($50 per unit), but Medicare would likely pay
only $220 (about $22 per unit). And the landscape can change. If, for
example, a large employer closes, many patients in that area may shift
from commercial insurance to Medicaid (or no insurance).
Your case volume. Naturally, the more cases we do, the more
revenue we generate (assuming patients are covered). If a case
cancels and we're stuck just sitting around, that means no revenue. If
a surgeon cancels a day's cases, the day becomes a total loss. Or if a
high-volume surgeon slows down, moves away or retires, revenue will
likely decrease. Anesthesia providers who are salaried or hourly
employees don't have to worry; they get paid regardless. But the anes-
thesia contract-holder doesn't have that luxury.
Case delays and speed of turnover. We've all heard surgeons
complain about slow turnover and delays. Anesthesia contract-
holders have the same concerns. We should help facilitate turnover,
and never cause unnecessary delays.
Non-revenue generating services. Some facilities require serv-
ices such as on-call coverage for trauma or OB in hospitals, guar-
anteed room coverage in ASCs (even if no cases are scheduled), or
on-site providers who don't actively participate in cases (such as
supervising anesthesiologists or floaters to help with turnover).
Someone has to pay for these. If they're not covered by the facility,
the money comes right out of anesthesia revenue.
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