The annual anesthesiology conference is back in full force! It was great to see the conference return to pre-pandemic attendance at the Anesthesiology 2023 Conference in San Francisco, California. The Fusion Anesthesia booth was busy, and we had some great conversations with Residents as well as hospital employed and private practice anesthesia providers.
Below are just a few noteworthy topics:
Payer Contract Negotiations (or lack thereof): Many providers that stopped by the Fusion booth expressed frustration with payers and their refusal to “negotiate” fair market pricing – especially while most of these payers are posting record profits. As we discussed in our Revenue Cycle Health series (The Importance of Payer Contract Negotiations in your Anesthesia Practice (fusionanesthesia.com) you must begin negotiations by demonstrating your value with data and don’t underestimate the power of maintaining a relationship with your payer provider representative. Be on the lookout for the ASA’s 2023 Conversion Factor Survey Results to be published this month. While the dataset is limited by the number of practices that participate, it still provides valuable insight into the payer landscape nationally.
The No Surprise Act (NSA): It seems this year the Act brought about nothing but surprises. We spoke with providers that have had success going out of network with the QPA (Qualified Payment Amount) yielding an increase in reimbursement while other providers experienced quite the opposite forcing conversations with their facilities for increased support. However, there may be some good news on the horizon for anesthesia providers. On August 24, 2023, the US District Court for the Eastern District of Texas issued an opinion and order in TMA III that states: A number of provisions related to the QPA methodology, including the inclusion of contracted rates for items and services “regardless of the number of claims paid at that contracted rate,” the use of contracted rates of all self-insured group health plans administered by the same entity, rules governing calculation of the QPA for providers “in the same or similar specialty,” (FAQS ABOUT CONSOLIDATED APPROPRIATIONS ACT, 2021 IMPLEMENTATION PART 62 (cms.gov). Fusion Anesthesia Solutions continues to monitor NSA changes and updates that affect anesthesia providers.
If you’re interested in learning more about Fusion and how we support our clients with payer contract negotiations, the NSA and other issues, contact email@example.com.