HANDS ON DECK Outsourcing anesthesia gives you access to skilled professionals and control over the services they provide.

The most compelling argument for contracting with an anesthesia group or management company is that it gives your facility the ability to use the market to your advantage. Bidding out business facilitates competition, creativity, and quality and cost management, keys to success in the current healthcare economy.

There's nothing like competition to encourage anesthesia providers to explore and understand your business objectives and to creatively package their offerings into a deal benefiting both parties. In a specialty that is often defined by its adversity to risk, this can develop better solutions, or at least solutions that are more focused on the future than the past.

That's not the only advantage of contracting anesthesia services, though. It can also bring better, more committed clinical partners to your ORs. At the same time, it's based on a contract that remains in force only as long as your service requirements are being met. In short, it gives your facility access to skilled professionals and control and leverage in their performance. But the selection process can be challenging and always involves some degree of risk. So keep these 3 factors in mind:

• Do you like the providers? Your facility's leadership must feel comfortable with the proposed staff. They must be experienced, credible and sympathetic. What level of commitment and resources will they bring to the contract? Be wary of companies that send in one team to sell the deal, but send in another to provide the services, and of those that don't have longstanding relationships with their clinicians.
• Does the company know your business? The company must fully understand and appreciate your facility's goals and objectives, and the challenges in reaching those goals. Their interests and vision for success must be aligned with yours, and you must perceive their solutions as realistic and appropriate. Local is usually, but not always, better than remote, but credibility is crucial.
• Can they deliver the goods? The company's track record and references must confirm their ability to make good on the promises and representations they've made during the sale. This may be the most important factor of all. Inspect, don't expect.

Any resulting contract should reflect a dialogue on accountability, collaboration and innovation. Its provisions should clearly define roles, responsibilities and service requirements in terms that can be measured and monitored to ensure consistent accountability. A good anesthesia group will welcome meaningful benchmarking and a collaborative partnership.

At the end of the day, a surgical facility outsources in order to draw on core competencies that it does not possess in-house. But health care is also a competitive environment, and the contracted provider must also be able to bring innovative new ideas to the relationship. Don't rush the process. Take the time to define your facility's needs and expectations, and don't settle for second-best. As you know, in health care relationships matter.

AccuCare
accucarepartners.com
(240) 406-1691
Geographical coverage: AccuCare has clients in the Baltimore, Md.-Washington, D.C. area, "but our solutions can be customized for any location," says the company.
FYI: AccuCare's nationwide database of MD anesthesiologists and CRNAs let outpatient surgery and endoscopy centers cut down on costly overhead and let physicians focus on patient care. AccuCare offers competitive management fees based on collectibles. The company's experience with anesthesia management promises skillfully negotiated contracts for high reimbursement with minimum risk.

AmSol
amsolusa.com
(800) 589-6315
Geographical coverage: Eastern U.S.
FYI: Owned and managed by anesthesiologists, CRNAs, hospital executives and CPAs, AmSol's anesthesia management and consulting services utilize a proprietary metrics software that captures real-time quality and efficiency data. Customized solutions can be created for any solution, facility or budget.

Epix Anesthesia
epixanesthesia.com
(855) 888-3749
Geographical coverage: National
FYI: An independent anesthesia management company with more than 50 years of collective experience in the industry, Epix Anesthesia delivers flexible, adaptable anesthesia solutions for superior patient care and increased productivity. To bring its expertise and resources to its clients, the company offers a range of different business models whose pricing structures are based on location, size, specialties, payor mix, ownership structure and other factors.

Excel Anesthesia
eakc.net
(913) 721-3641
Geographical coverage: Primarily Kansas and Missouri, including Kansas City metro, Topeka, St. Joseph, Sedalia, Independence and Leavenworth.
FYI: For more than 16 years, Excel Anesthesia has delivered cost-effective anesthesia services to hospitals and surgical centers without sacrificing quality outcomes. The company counts exceptional training, comprehensive experience and compassionate care as the hallmarks of its business. Services and fees vary depending on a facility's need. Direct billing for anesthesia services and daily rates are common contract options.

Healthcare Performance Anesco
drivinghp.com/anesthesia
(855) 566-7590
Geographical coverage: Florida
FYI: An independent contractor that counts 40 MD anesthesiologists, 53 CRNAs and 27 SRNAs among its ranks, Healthcare Performance Anesco covers 52 surgical sites, including cardiac, trauma, OB-GYN and pediatric specialists, and provides services for more than 55,000 surgical procedures annually. HP Anesco is the exclusive provider of anesthesia and pain management services to Broward Health, one of the nation's 10 largest public health systems.

LifeLinc Anesthesia
lifelinc.com
(901) 844-1590
Geographical coverage: National, headquartered in Memphis, Tenn.
FYI: In hospitals, ASCs and office-based practices, LifeLinc seeks to reduce anesthesia costs while maintaining or improving the efficiency and quality of care provided. The company's expertise in the clinical practices as well as the financial aspects of anesthesia services drive its anesthesia management and consulting services. LifeLinc's traditional management models do not incur costs to contracting facilities and its consulting services are structured on a project-by-project basis.

Mobile Anesthesiologists
zzzmd.com
(866) 997-7770
Geographical coverage: Chicago, Ill.; Illinois statewide; Houston, Texas; North Carolina; Georgia; Florida; Rochester, N.Y. and Detroit, Mich.
FYI: With a focus on office-based surgical facilities, Mobile Anesthesiologists delivers staffing and turnkey solutions for ambulatory anesthesia services. The company provides a board-certified (or -eligible) anesthesiologist, ICU- and ER-experienced nurses for pre-op and recovery, and all necessary drugs, supplies and equipment for the procedure and any possible emergencies. An independently contracted direct billing provider, its locations in 8 major markets give the company national reach, but it caters to local needs.

NorthStar Anesthesia
northstaranesthesia.com
(817) 861-3994
Geographical coverage: National, based in Arlington, Texas
FYI: Founded by an anesthesiologist and a CRNA, NorthStar Anesthesia partners with more than 60 facilities in 9 states to provide quality care while improving efficiency and accountability. A performance-driven approach to anesthesia management ensures the best service for administrators, surgeons and patients, says the company. Working closely with facilities to define staffing models that meet clinical and financial needs, NorthStar utilizes electronic medical records to track service and quality metrics and operates through a pay-for-performance system to keep staff focused on facilities' goals.

RemCare Anesthesia Solutions
remcareanesthesia.com
(814) 201-2523
Geographical coverage: Pennsylvania, Maryland, Virginia
FYI: RemCare Anesthesia Solutions, based in central Pennsylvania, has been serving hospitals, ASCs and endoscopy centers since 2004. The practice specializes in providing ambulatory anesthesia for orthopedic, ENT, endoscopy and ophthalmic procedures, including anesthesia services for outpatient total joint replacements. RemCare operates primarily on a fee-for-service basis, but can also provide temporary staffing on a contract basis.

Somnia Anesthesia
somniainc.com
(877) 476-6642
Geographical coverage: National
FYI: Owned and operated by anesthesiologists since 1996, Somnia provides a turnkey, solutions-based approach to anesthesia management. An extensive in-house infrastructure and competitive agreements with payors nationwide enable the company to build and manage local anesthesia teams that deliver quality patient care, OR performance, increased revenues and surgical satisfaction at hospitals, ASCs and office-based surgical facilities. In most facility contracts, the company bills and collects for the anesthesia services it provides, requiring no subsidy from the client.

Synergy Anesthesia
synergyanesthesia.com
(973) 200-8224
Geographical coverage: New Jersey, New York, Pennsylvania
FYI: Synergy Anesthesia is a physician-owned and operated anesthesia management company serving ASCs and office-based facilities. All of its anesthesiologists are trained specifically in the field of ambulatory anesthesia and aim for patient safety as well as efficiency. In addition to providing clinical care, the company also offers such additional services as accreditation consultation, management solutions, workflow optimization and didactic teaching. Coverage models include full-time, part-time and per diem options, depending on clients' needs, and remuneration can be arranged through fee-for-service insurance billing or an hourly, daily or even monthly fee schedule.

MH EMERGENCY
A Faster Way to Mix Dantrolene

IN THE MIX The quick reconstituting of dantrolene could mean the difference between life and death.

Use large-bore propofol spikes for mixing dantrolene during malignant hyperthermia emergencies. Connect large drop tubing to a bag or bottle of sterile water and withdraw the fluid from the tubing port. Spike a dantrolene vial with a vented adapter, inject the sterile water, mix and withdraw the spike, then pass the reconstituted drug to the anesthesia provider for injection. The large-bore spikes allow for faster withdrawal of the sterile water, faster mixing and faster delivery of the critical treatment to stricken patients. They're real timesavers and, ultimately, true lifesavers.

Carol Zoellner, RN, CNOR
Williamson Surgery Center
Round Rock, Texas
[email protected]