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Anesthesia Workforce Shortage: Part 2

Navigating finances during the current provider shortage

Healthcare economics have always been defined by the supply of providers and demand for services. In Part 2 of our “Anesthesia Workforce Shortage” series, we discuss the impact of the current demand/supply imbalance, and how hospitals and providers can navigate their finances during the provider shortage.

Howard Greenfield, MD podcast with Becker’s

This episode features Dr. Howard Greenfield, Principal at Enhance Healthcare Consulting & Board Certified Anesthesiologist. Here, he discusses what led him to build Enhance Healthcare Consulting, challenges surrounding the shortage of anesthesiologists & the costs associated with labor, and more.

Anesthesia Workforce Shortage: Part 1

How did we get here, and what are the implications?

The healthcare industry is facing an escalating anesthesia workforce shortage. In Part 1 of our “Anesthesia Workforce Shortage” series, we evaluate trends and common themes that have led to this misaligned supply and demand, and what this means for the future of the market.

Protected: Is Your Anesthesia Group an Asset or a Liability?

How your group can increase the value of perioperative services at your hospitals and ambulatory surgery centers

In this whitepaper, Enhance Healthcare outlines four key strategies for anesthesia groups to become an indispensable asset to their hospitals and ambulatory surgical centers.

The Changing Landscape Of the RFP

As advisors to both provider groups and hospitals, EHC has been involved in over 50 RFP’s in the last 20 years

Enhance Healthcare Consulting has seen approximately a fivefold increase in the issuance of RFP’s, with 30% of hospital based RFP processes resulting in a provider change.

What Do Hospitals Want From Anesthesia Groups?

Hospitals' Top 10 Expectations of Anesthesia Groups

Anesthesia groups have many issues to deal with, including pressure on reimbursement and hospital subsidies. Despite these concerns, it is important to remember that for many groups, their key asset is their hospital contract.

The RFP Process: Steps For Getting The Most Accurate Bids

With the reality of shrinking margins, hospitals find themselves in a place where they must evaluate all major expenditures

Distributing a request for proposal (RFP) for a HBP service line can often be a painful process and one which should not be taken lightly.

Anesthesia Finances in the Age of COVID-19

Full Series

Our four-part series on the financial and operational implications of the COVID-19 pandemic on hospitals, healthcare systems and anesthesia groups.

Anesthesia Finances in the Age of COVID-19

Part 4 - The Journey After COVID-19

In Part 4 of our series, we will now consider the likely New Normal in the immediate aftermath of COVID-19 and explore a number of reasons why that sudden surge in volume and revenue may not materialize in the manner anticipated.

Anesthesia Finances in the Age of COVID-19

Part 3 - Impact of Responses on Post Virus Performance

While our focus in the previous models was on the immediate financial impact on both contracted entities, this installment will attempt to analyze the impact on facility finances in the first few months after the virus threat has stabilized to the point where elective surgical cases are able to resume.

Anesthesia Finances in the Age of COVID-19

Part 2 - Impact of Common Early Responses

Our objective for this installment of our series is to model the impact of several examples of these changes on anesthesia group finances. As we did previously, in order to demonstrate the impact in various scenarios, our example will use a group staffing 10 locations, with three distinct staffing models.

Anesthesia Finances in the Age of COVID-19

PART 1 – Impact of Maintaining Existing Subsidy Structures

Subsides may be structured in many ways, the most common being fixed stipends and revenue guarantees. Each structure has pros and cons, but in a sudden financial upheaval caused by COVID-19, hospitals or anesthesia groups will be significantly harmed depending on the structure chosen.

The 5 C’s of Group Leadership

Key to Successful Hospital-Based Physician Leadership

Hospital-based provider groups are a vital bridge between the business leaders of the facility and its medical staff. Hospital executives frequently cite a lack of leadership as a limiting factor in the performance of their facility-based groups.

Billing Optimization

The Foundation of Improving Anesthesia Financial Performance

Whether you are a hospital paying an anesthesia subsidy or a group trying to maximize profitability, it is in your best interest to monitor and optimize anesthesia revenue realized from payers and patients.

Your Hospital Issues An RFP For Anesthesia Services: Now What?

When hospitals seek alternatives to their existing anesthesia group

As a national anesthesia consulting firm, we are seeing hospitals and healthcare systems change or attempt to change their incumbent anesthesia groups with increasing frequency.

Management Services Organizations: Leveling the Playing Field for Small and Local Groups

Leveling the Playing Field for Small and Local Groups

In the Healthcare environment of 2018, it seems that "bigger is better" is the mantra from all sides. We've got hospital systems consolidating, huge insurers combining, giant national provider groups forming...

6 Steps for Anesthesia Practices Considering Selling

Steps to follow when deciding whether to sell one's anesthesia practice

Howard Greenfield, MD, principal of management and consulting firm Enhance Healthcare, described several steps to follow when deciding whether to sell one's anesthesia practice.

Uncovering Key Data Points To Improve Or Profitability

EHC's data analysis targets areas for performance improvement in the operating room (OR)

Hospital finance leaders can increase profit from operating rooms by developing performance improvement plans around key statistics, such as utilization, delays, and unique morning starts.

4 Ways Anesthesia Can Help Hospitals Reach Health Reform Goals

Two of the main goals of the Patient Protection and Affordable Care Act are to increase quality and lower costs.

Here are four examples of ways anesthesia providers can help hospitals reach these goals.

F-O-C-U-S: 5 Key Factors of Anesthesia Success

The benefits and challenges of a co-managed anesthesia model

Drs. Greenfield and Stiefel present a new framework hospitals can use when thinking about anesthesia services.

Physicians’ Role in Patient Satisfaction

Physicians play a large role in patient satisfaction.

Anesthesiologists can affect patients' satisfaction by overseeing preoperative preparation, ensuring the patient understands the process for the day of surgery and managing postoperative pain.

How Preoperative Preparation Can Drive OR Performance

One way to make the OR more efficient is to focus on preoperative functions

Some key preoperative responsibilities that can improve intraoperative metrics, including start times, turnover time and OR utilization

Anesthesia 101: Coverage Models

On average, the OR generates 70% of a hospital’s total revenue. Healthcare leaders are looking to optimize this profit center

Knowing your options, as well as understanding your needs, will help you choose the model that is best for your hospital, your surgical staff and your community.

Anesthesia 101: Service Expectations

Understanding which anesthesia model is right for your facility

Hospitals have specific goals regarding patient and surgeon satisfaction as well as growth initiatives. Your facility's anesthesia model should help you meet those goals.

Anesthesia 101: Subspecialty Needs

Is your hospital’s current anesthesia coverage effective and efficient or should you explore an alternative model?

Critical care. OB. Pain. Cardiovascular. Pediatric. Anesthesia sub-specialties have evolved to address an often complex and challenging subset of patients. Each come with their own set of needs.

Anesthesia 101: Stakeholder Needs

Anesthesia services must be considered from the viewpoint of multiple stakeholders

The needs of each of these stakeholders are diverse and when taken together, serve as a way to measure the affect of an anesthesia model on the health of the overall facility.

Anesthesia 101: Business Models

Healthcare has changed. And so have anesthesia business models

The healthcare environment has dramatically changed in recent years, and anesthesia business models are evolving as well. If current trends hold, three types of business models will emerge as the industry standard.

Anesthesia 101: Anesthesia Subsidy Drivers

Anesthesia subsidies often cost hospitals millions of dollars.

With eighty percent of hospitals paying an anesthesia subsidy, finding ways to reduce these costs – without risking quality – is critical, while supply-demand imbalances dramatically drive up subsidy requirements.

Pre-Op Your Anesthesia Practice

More anesthesia groups than ever are about to undergo the business equivalent of an invasive procedure

A “pre-operative” assessment of your own practice will reveal how your group will look to a possible partner, investor or employer before your group is in the middle of negotiations with another entity.

‘Get Big Fast’ Multispecialty Outsourcing Expert Warns Radiology Of Things To Come

Change is coming to radiology in ways the profession could not have anticipated

The forces driving the change are many, but one common denominator has emerged: hospitals under intense pressure to perform in order to survive.

Strategy And Adaptability In A Competitive Market: Lessons From The Nation’s Largest Anesthesia Organizations

As of April 2017, eight entities employed more than 22 percent of all anesthesia providers in the United States.

The size and scope of these entities could not have been envisioned just a decade ago. The entities profiled below represent those that, for the time being, appear to have successfully positioned themselves in the new market.

Renegotiated Payor Contracts And Improved Collections Significantly Boost Anesthesia Revenue

The CFO hired Enhance to help the health system optimize its revenue cycle.

Due to lack of oversight of the anesthesia revenue cycle, this small Southwestern health system suspected it was not capturing all professional fee revenue, and wanted more accurate and timely financial reporting.

Enhance Healthcare Releases Recent Anesthesia Survey Results

An inside look into how and why hospitals seek new anesthesia providers.

The RFP process has become much more standardized, and the options for change more robust, while at the same time the financial and operational imperative for change has escalated.

Leadership And Technology Enhancements Allow Cost-Effective Expansion Of Coverage

Our assessment uncovered an inefficient scheduling system and a lack of anesthesia leadership within the system.

A tertiary care facility in the South, part of a four hospital system needed to improve coverage amongst all its facilities without incurring a substantial increase in cost.

Improved Revenue Cycle Solution Increases Collections By 37% And Reduces Subsidy

EHC's anesthesia-specific analysis verified that the anesthesia revenue cycle was not optimized.

SITUATION: Three years in a row the amount of subsidy had increased – 15%, 12% and 20% respectively – despite the fact that their coverage requirements had not changed. 


An inside look at Enhance Healthcare's approach

SITUATION: An important Surgical Service Line expansion forced a West Coast community hospital to face a dramatic increase in anesthesia costs that threatened its financial viability.


Savings result from EHC's complete evaluation of physician leadership, quality standards and OR efficiency

SITUATION: A 321-bed community hospital in the Southeast United States was experiencing significant financial challenges due to its high anesthesia costs.

EHC Solution Establishes Pediatric Care Capabilities In Community Hospitals

Enhance Healthcare Consultants developed a comprehensive, cost-effective solution

SITUATION: A major hospital system faced serious financial challenges in attempting to meet critical needs in its local communities.

OR Efficiency and Throughput

Benchmarking and Process Optimization

Dr. Robert Stiefel discusses the heightened importance of OR efficiency to hospitals.

Anesthesia Group Changes

You are a 15-person Group. Time for a Change: What are you going to do?

Dr. Greenfield shares insights on how anesthesia groups can stay afloat in the face of growing group consolidation.