CSA Online First

CSA Online First is a weekly blog featuring insights from CSA members themselves.

Edited by Rita Agarwal, MD, FAAP, with contributions from CSA’s Committee on Professional and Public Communications, Online First is a place where knowledge and opinion from any one of our 3200 plus physician-anesthesiologist members can be shared, discussed and deliberated to advance the specialty of anesthesiology, the practice of medicine and society in general.

"Better solutions to difficult problems are usually made when all sides are heard."

Steven Goldfien, MD

 

CSA is Committed to You and Your Practice

by
  • Butler, David, CSA Executive Director
| Jun 11, 2018

Your physician leaders at the California Society of Anesthesiologists have made a number of changes over the last year to better serve you, our members.  We increasingly appreciate that physician anesthesiologists have a number of places where they can invest their time and their treasure to benefit their practice and their patients. We want to do all we can to ensure that CSA is your professional home as physician anesthesiologists in California.

One area in which we have dedicated additional emphasis is in the area of Practice Management. CSA leaders want to be a resource for our members to rely upon for information that helps them better serve their patients and also advance the operational and financial performance of their practices.

Our first step in this direction was to establish a separate Practice Management Committee within the existing Legislative and Practice Affairs Division. Chaired by Keith Chamberlin, MD, MBA, FASA, the committee brainstormed a variety of ways to deliver value to members in practice management and was preparing presentations on a number of topics – and then, in the words of Dr. Chamberlin – AB 72 happened. 

AB 72 (Bonta), which sought to address public concerns about out-of-network billing, was signed into law by Governor Brown in October, 2017, after which the Department of Managed Health Care and the Department of Insurance were tasked with developing regulations to direct implementation. Working with CSA’s lobbyists at KP Public Affairs, Dr. Chamberlin and members of the Practice Management Committee worked to engage in the process to ensure the regulations treated anesthesiologists fairly. 

CSA has been effective in shaping draft regulations including clearly delineating the Anesthesia Conversion Factor (ACF) as an element of the Average Contacted Rate; clearly defining claim settlement practices; and supporting the use of a statistically credible database that is unaffiliated with a payor.

CSA lobbyists and Practice Management leadership will continue to engage in this process over the coming months to ensure AB 72 does not jeopardize your ability to come to fair contact terms with your plan partners.

Another place CSA’s Practice Management leadership has had an important impact was at our most recent Annual Meeting and Workshops, held March 23-25 in Palm Desert.  The program chairs for the Annual Meeting, Shalini Shah, MD, and John Brock-Utne MD, PhD, worked closely with Dr. Chamberlin who developed an entire section on important practice management topics, featuring top-level presenters.

The first session featured Asa Lockhart, MD, MBA, a consultant and physician anesthesiologist from Tyler, Texas, who discussed MACRA and the federal vision of alternate payment models; Sam Wald, MD, MBA, and current CSA President discussed qualities of leadership and how to apply them in your hospital; and Ron Pearl, MD, PhD, chair of the Dept. of Anesthesiology and Perioperative Medicine at Stanford University Medical School, discussed the topic of professionalism in anesthesia. 

The second session featured Judy Semo, JD, who practices law in Washington, DC and specializes as legal counsel to anesthesiology practice groups, discussed contracting in today’s changing medical climate; and Dr. Brock-Utne, whose topic was “The Joint Commission vs. Hospital Administration vs. Physicians.”

Both panels were exceptionally well received by attendees who were anxious to learn more and apply lessons learned to their own practices.

The Practice Management section will once again be a key element of CSA’s Annual Meeting and Workshops in 2019, scheduled for March 7-10 at the Paradise Point Resort in San Diego’s Mission Bay.

A third way CSA members can benefit from our renewed focus on practice management is the opportunity to obtain advice from and consultation with practice management leadership including Dr. Chamberlin and, when appropriate, CSA Legal Counsel Phillip Goldberg and CSA lobbyist Bryce Docherty. 

As an example, just this week a private practice physician anesthesiologist from the San Diego area contacted the CSA office seeking advice concerning an endoscopy center that was informing him that their use of physician anesthesiologists was prohibited by regulations promulgated by the California Department of Public Health and they were “required” to use CRNAs to perform anesthesia services. 

Dr. Chamberlin, Mr. Goldberg, and Mr. Docherty “teamed up” to inform him that it was likely the endoscopy center was incorrectly using the “opt-out” legislation to support a management decision about the use of CRNAs vs. physician anesthesiologists. 

“Life is what happens while you are planning other things.” And Practice Management is what happens while you are working on legislation fixes and broad medical topics. The Practice Management Committee is dedicated to developing strategies to help you with the challenges of your day to day practice issues. 

If you have topic ideas and/or would like to become involved in CSA’s Practice Management Committee, please contact Dr. Chamberlin at kjcacm@gmail.com.

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