A West Coast community hospital wanted to avoid a requested 80% anesthesia subsidy without sacrificing quality. The hospital was utilizing an all-anesthesiologist model to cover 8 staffed ORs, a busy OB department, and one provider for out of OR cases. The increased subsidy request was based on the hospital’s need to open one additional anesthetizing location and to have an anesthesia provider available each business day in pre-admission testing. The net projected cost of the additional staffing in this all-anesthesiologists model was $800,000.
The hospital engaged Enhance Perioperative & Anesthesia Consulting (EPAC) to evaluate their entire anesthesia service line and recommend cost-saving options.
UNDERSTANDING OPTIONS AND ENGAGING SURGICAL STAFF
EPAC began by modeling the detailed anesthesia coverage requirements both during “staffed hours” and on call. Several alternative coverage models were developed, including utilization of CRNAs. Each of these models provided savings as compared to the requested subsidy increase.
Together with the hospital leadership, EPAC narrowed the acceptable options to three models. Then EPAC and the hospital’s OR manager met with surgical and anesthesia leaders to discuss in detail the clinical implications of each model. During these discussions, the anesthesia coverage models were adjusted slightly to allow more flexibility. A new model was agreed upon and implementation occurred over the course of 9 months.
ACHIEVING RESULTS AT A LOWER COST
- The initial subsidy amount was reduced by 40%
- The 80% subsidy request was avoided
- The new staffing model was implemented in 9 months
- Hospital coverage increased to accommodate 1 additional anesthesia location
- Surgeon satisfaction improved