How Anesthesia Quality and Efficiency Impact Hospital Reimbursement

Patient satisfaction, quality of care and operating room (OR) efficiency are at the forefront of today’s healthcare marketplace. Officials at the Centers for Medicare & Medicaid Services (CMS) have devoted significant effort to associating the patient experience with pay-for-performance. The foundation of effective pay-for-performance programs is the collaboration with healthcare providers and other key stakeholders to encourage improved quality of care in healthcare settings. This is accomplished through the development of meaningful quality metrics which enable providers to achieve actual improvements in the delivery of patient care.

According to an article written by Accenture in 2016, U.S. hospitals that deliver “superior” customer experience achieve net margins that are 50 percent higher, on average, than those of hospitals providing an “average” customer experience, making patient satisfaction an important revenue indicator[1]. Per CMS, the average annual healthcare expenditure per person is $11,000, placing additional importance on each new and return patient. Beyond the obvious reimbursement impacts, satisfied patients are more likely to refer their friends and family members to facilities that offer outstanding service. These factors combined demonstrate how critical it is to provide a superior patient care experience for hospital CEOs who wish to achieve high net margins.

The anesthesia care team should play a key role in improving patient satisfaction throughout the perioperative experience. On a daily basis, anesthesia providers are uniquely positioned to lead improvements across the perioperative continuum by improving efficiency and quality outcomes through clinical performance. Unfortunately, this opportunity is rarely seized by anesthesia providers because their organizational objectives are often in conflict with the goals of other OR stakeholders.

Hospital administration's ability to improve perioperative quality and efficiency is minimized when anesthesia is not leading the charge. A high-functioning anesthesia management relationship should allow hospital executives to conveniently view quality and efficiency data and surgeon OR utilization, while assisting the hospital administrators in affecting the key drivers of these data points to improve performance. Furthermore, performance metrics should be updated frequently and tracked monthly to ensure the anesthesia department is always on track to continuously lead improvement.

Anesthesia teams that are focused on quality and efficiency produce patient experiences that are "superior" rather than "average" and lead to increased hospital reimbursement by improving patient outcomes. In addition, increased quality and efficiency have a positive impact on patient satisfaction, thus contributing to a greater likelihood of repeat business from satisfied patients.

Over the next few months, we will be publishing more detailed content on how to provide a superior patient experience by focusing on OR quality outcomes and efficiency. We value your feedback and would like to include your input in our upcoming article series. Please take a moment to complete a 30 second survey regarding these important topics related to quality and efficiency. Thank you in advance for your participation!