Anesthesiology Digest – February 26, 2021

March 1, 2021

Anesthesiology Digest: News from February 2021.

Anesthesia Market to Hit $2.4B by 2025, Market Report Says

By Eric Oliver | February 23, 2021

The U.S. general anesthesia drug market is projected to hit $2.4 billion by 2025, according to a Feb. 22 report from

The market was worth around $2 billion in 2020. The analyst firm believes the U.S. anesthesia market will grow at a compound annual growth rate of 3.4 percent from 2020-25.
The firm believes an aging population, increasing cancer numbers and growing emergency surgery rates will drive the anesthesia market’s growth.

The hospital sector holds the largest share of the market, and it’s expected to remain that way through the forecast period.

To read more, go to Becker’s ASC.

What Entrepreneurs Can Learn From The Healthcare Industry’s Covid-19 Response

By Rhett Power | February 21, 2021

The healthcare industry was put to the test last year due to the pandemic, and a lot of innovation shone through—from new drugs and medical devices to supply-chain breakthroughs and better collaboration processes. Business leaders from all areas of the industry found new ways to accelerate growth to support the common good and generate critical revenue.

In a McKinsey survey of more than 200 organizations across industries conducted in June 2020, more than 90% of executives believed Covid-19 would fundamentally alter how they do business over the next five years. Almost as many said the crisis would have a lasting impact on their customers’ needs. However, more than three-quarters agreed that the pandemic will create significant new opportunities for growth, although this varies significantly by industry.

In a retrospective endeavor, I connected with half a dozen business leaders and entrepreneurs in the healthcare space to see what they learned and experienced over the past year:

  1. T. Scott Law Sr., Founder and CEO at Zotec Partners
    As Covid-19 crashed down, Zotec Partners reacted quickly and leveraged its revenue cycle management technology to build a multifaceted solution to manage testing and vaccinations across the state of Indiana. To date, this solution has facilitated more than 500,000 tests and over 1.1 million vaccines—creating a seamless patient experience, automating processes for providers, and delivering custom dashboards to track Covid’s spread and vaccine deployment.
    “This experience has been an exercise in perseverance, and until the need no longer exists, we’ll continue to deploy innovative solutions to meet the current healthcare challenges,” Law said. “Relationships matter. Zotec values personal connections, and only because of this were we able to engineer so many impactful solutions. When it comes to business, people choose people, and that’s what makes a difference in times of crisis or calm.”
    To read more, go to Forbes.

ASA Provides Recommendations to FDA on REMS Program

February 20, 2021

On February 9, 2021, the American Society of Anesthesiologists (ASA) urged the Food and Drug Administration (FDA) to ensure alignment between REMS education programs and existing accreditation and state education requirements. The request came through formal comments submitted to the Federal Register in response to the FDA’s Request for Comments; Evaluating the Effect of the Opioid Analgesics Risk Evaluation and Mitigation Strategy (REMS) Education Program on Prescribing Behaviors and Patient Outcomes–Exploring the Path Forward for Assessment. ASA’s involvement with the FDA REMS program has a long history, including the agency’s adoption of several recommendations submitted by the ASA in 2011 and more recently, FDA’s decision to expand the program to cover all classes of opioids in 2017.

ASA’s comments praised the FDA for their continuity in tackling the nation’s opioid overdose crisis and for implementing this continuing education (CE) program that comes at no costs to physicians. Key recommendations included encouraging REMS education to follow traditional Accreditation Council for Continuing Medical Education (ACCME) standards for accredited CME providers, conducting a pilot study about the effectiveness of REMS-compliant CE, as well as ensuring REMS education fulfills state education requirements.

The Vice-Chair of ASA’s Committee on Pain Medicine, Michael Harned, MD, provided comments at FDA’s public workshop on December 11, 2020. He offered remarks and presented ASA’s feedback, consistent with the formal comments submitted to the FDA. ASA’s recommendations reflect the organization’s overall commitment to supporting the REMS education program and making it more accessible and influential in reducing opioid overdoses nationwide.

To read more, go to ASA’s website.

Where Nominated CSM Administrator Brooks-LaSure Stands on 4 Key Issues

By Michael Brady | February 19, 2021

Chiquita Brooks-LaSure is President Joe Biden’s pick to lead CMS. Colleagues describe the long-time Beltway insider as a consummate professional and point to her experience and track record in Washington.

“America’s hospitals and health systems applaud the nomination of Chiquita Brooks-LaSure to serve as the next administrator of the Centers for Medicare & Medicaid Services, the American Hospital Association said in a statement. “Her previous experiences as a senior CMS and HHS official who helped implement the Affordable Care Act and her work on the House Ways and Means Committee gives her a deep understanding of the importance of healthcare coverage and protections for consumers.”

In addition to her work on the Affordable Care Act during her time on the House Ways and Means Committee, Brooks-LaSure has worked on Medicare, Medicaid and commercial insurance at the White House budget office and CMS. She’s also advised providers, insurers, life sciences companies and states on a wide range of healthcare issues. Most recently, she led the HHS agency review team during the Biden-Harris transition.

Her former boss, Clinton administration official and Avalere Health founder Dan Mendelson, called her a “team player,” saying that she would carry out Biden’s healthcare agenda rather than push specific issues of interest if she’s confirmed.

Ruth Tabak, director at consulting firm Berkeley Research Group, overlapped with Brooks-LaSure during her earlier stays on Capitol Hill and CMS. She expects her former coworker to run an orderly agency that’s committed to developing and implementing effective, durable policies with considerable input from providers, payers and other stakeholders. The future CMS leader knows the agency must get buy-in from providers and insurers since they’ll play critical roles in putting CMS policies into practice, Tabak said. She doesn’t expect too many of the agency’s policies to get tied up in court because Brooks-LaSure would likely take a measured approach to rulemaking.

Here’s what we know about the nominated CMS administrator on four key issues.

  1. Coverage expansion and affordability
  2. Health equity
  3. Surprise billing
  4. Value-based payment
    To read more, go to Modern Healthcare.

Here’s How Far Medicare Claims Dropped Last Spring Due to COVID-19

By Robert King | February 19, 2021

COVID-19 caused a massive 51% drop in outpatient Medicare fee-for-service claims last April compared to 2019 as the pandemic reached full swing, according to a new analysis.
The analysis, released Tuesday from consulting firm Avalere Health, sought to explore the impact of the pandemic on healthcare utilization from March through May. The pandemic caused doctors’ offices to close and hospitals to shutter elective procedures to preserve capacity to fight the virus.

“The impact of delayed or avoided care on the health status of Medicare beneficiaries will need to be examined over the following months and years as there could be lasting effects even as the pandemic recedes,” the analysis said.

Avalere found the greatest drop in claims for Medicare fee-for-service occurred in April. The biggest decline was the 51% drop of outpatient claims compared with 2019, compared with a 42% drop for inpatient fee-for-service claims and a 23% drop for professional and physician service claims.

The consulting firm looked at a random sample of Medicare Part A and B fee-for-service claims between January and June 2019 and the same time frame last year.

The declines started to occur in March, when lockdowns began to spread across the country. Outpatient claims declined by 18% that month and inpatient claims by 13%.

Increases also weren’t as pronounced in May, when states started to ease lockdowns and shelter-in-place orders. Outpatient claims declined by 32% in May 2020 compared with 2019, and inpatient by 25%.

Claims also started to rise slowly in June as inpatient rose by 3% compared to 2019 and professional/physician services by 4%. However, outpatient claims continued to decline and were down 1% that month.

To read more, go to Fierce Healthcare.

CMS Pulls Back on Medicaid Work Requirement Policies

By Michael Brady | February 12, 2021

The Biden administration on Friday started to unwind a controversial Trump-era policy that allows states to force low-income residents to work, volunteer or take part in other so-called “community engagement” activities to enroll in Medicaid coverage.

The news comes just two weeks after President Joe Biden ordered federal health officials to reexamine policies that make it more difficult for individuals to access or afford coverage, including Medicaid work requirements. CMS withdrew a 2018 letter from former CMS Administrator Seema Verma to state Medicaid officials that invited them to apply for the waivers. The agency also reversed its approval for Georgia’s partial Medicaid expansion, which is now “pending.” CMS will also send a letter to 10 states with waivers for Medicaid work rules, informing them that the agency will repeal their waivers soon, Politico first reported. It in its letter to Arkansas, the agency said it had “preliminarily determined that allowing work and other community engagement requirements to take effect in Arkansas would not promote the objectives of the Medicaid program.”

“In the midst of the greatest public health emergency in generations, now more than ever, people with Medicaid need access to care. Medicaid’s primary objective, as set out by Congress, is to provide medical assistance in order to serve the health and wellness needs of our nation’s vulnerable and low-income individuals and families, based on need, not based on one’s ability to find work. This is not the time to experiment or test policies that risk a substantial loss of health coverage or benefits, especially for individuals and communities
significantly impacted by COVID-19 and other health inequities,” a CMS spokesperson said in an email.

Dan Mendelson, a former Clinton administration official and founder of consulting firm Avalere Health, said undoing the waivers is consistent with the Biden administration’s stated goal to increase the number of people with health insurance because the Trump-era “policy directly contradicts what they are trying to accomplish.” But it could take time to undo the waivers. Just before former President Donald Trump left office, Verma asked states to sign contracts that would make it more challenging for CMS to end states’ work requirements. Experts have questioned whether those contracts are legally enforceable.

The Biden team will need to review the contracts to see how much flexibility they allow. Mendelson said that Medicaid is an ongoing negotiation between the federal government and states because it is jointly funded and administered.

To read more, go to Modern Healthcare.

CMS Notice – Improving Accuracy of Medicare Payments

February 5, 2021

Please see the below notice from the Centers from Medicare and Medicaid Services (CMS). ASA members are encouraged to participate in these surveys if contacted by the Bureau of Labor Statistics. It is very important that CMS and other government agencies obtain current and accurate data, particularly as it may help shed light and help encourage a solution for anesthesia’s recurring problem of undervalued Medicare services – the 33% Problem.

Improving Accuracy of Medicare Payments

The U.S. Bureau of Labor Statistics (BLS) conducts numerous surveys of hospitals and health care providers that are used by the government to make economic decisions that affect the entire medical care system. Key users include CMS, the Federal Reserve Bank, and the U.S. Congress. CMS uses these surveys to adjust Medicare Fee-for-Service payments each year, affecting approximately $300 billion in payments.

If you’re contacted by BLS, please participate in the survey to help ensure the data are as accurate as possible. Recently, many health care providers didn’t complete the survey, which can reduce the representativeness of the data and increase volatility in estimates. Your participation in these surveys helps address these issues and increase the validity of the data. Participation is voluntary, confidential, and the data are only used for statistical purposes.

BLS Survey Respondents – webpage

Learn more about what Zotec Partners can do for your anesthesiology practice here.