The spectrum of issues arrayed before us as anesthesiologists practicing in California is broad and deep, both unique to our state, and also as local iterations of a national agenda. Certainly all members have heard of them before, but some folks have paid more attention than others. Below is my list of 29 important topics on the table for national, state or internal CSA action. This list will be updated on an ongoing basis. I strongly encourage every CSA member to comment and even propose additions to the list.
- The nurse anesthetist opt-out
- PPACA
- Performance measurement
- ACOs
- Advocacy
- Educational Mission - new and improved meetings and new CA meeting, workshops, web-based content, modules, newer modalities
- Single payer system in CA
- MICRA
- Federation of state medical boards and MOCA vs. MOSL
- AMRs and EMRs
- Bankrupt state treasury with public programs in the cross hairs
- Unsustainable increases in health insurance premiums
- Balance billing proscriptions
- SGR, 33% problem
- Potential for new collective bargaining entities, return to guilds
- AMA vs. coalition of national specialty societies, one big tent and/or reach across specialties, hospital-based, surgical, specialists, etc.
- Sedation protocols and training
- CMS IGs - single service, specified notes and timing
- Drug shortages
- Surveys by state and feds, drug labeling
- Changing areas of education and practice
- Diversion
- Workers Comp rates
- Poaching by other medical specialties
- Transparency and Truth in Advertising
- AAs
- Reorganization in CSA (Communications Manager, high level staff roles, website, communication to members)
- CSA Model Guidelines
- Insurance abuses, balance billing, underpayments and delays