the future, note no AA's, check it out boysArchived Message
Posted by robroy on August 31, 2009, 7:39 pm
There are changes in the economic landscapes of anesthesia contracts at large institutions in Washington State. In 2007, Northwest Hospital in Seattle decided not to renew the contract of a physician anesthesia group who had provided services to their community for many years due to a subsidy required by the anesthesia group for their services. This subsidy in seven figures was felt by the hospital to be non-sustainable and a new contract was granted to an anesthesia group, which organized and presented a bid to Northwest Hospital. Fast forward to 2009 in Everett, where Providence Regional Medical Center Everett previous contract of 24 MDAs ended. They are being replaced by 12 new MDAs and 18 CRNAs working together in a non-medically directed practice. This is a major transition for this institution with a talent exchange from longstanding and valued providers to a new group of talented providers. The difference is the changing economic landscape and the inability of organizations to subsidize practices to meet their financial demands. The question will be, “When is a practice subsidy really sustainable?” From these two examples, the answer may be rarely to never. (PRMCE) was presented with a sevenfigure subsidy demand by their physicianonly anesthesia group and faced contract negotiation. PRMCE determined also, as did Northwest Hospital, that this subsidy was non-sustainable as third party reimbursements were unable to cover services currently and less so in the future. PRMCE carefully considered large regional centers in the state like the University of Washington Medical Center, Sacred Heart Medical Center, Providence Centralia Medical Center, and local practices like The Everett Clinic. PRMCE found that an anesthesia model utilizing MDAs and CRNAs was both cost effective and provided a higher service level for their anesthesia services. CRNA's are unsupervised!!!!!!!!!, AA's can never be BY LAW!!!!!
