Anesthesiologists and the Transformation of the Healthcare System

With the enactment of the Affordable Health Care Act, the federal government is aggressively seeking to bend the healthcare cost curve by embracing a shift from a volume-based (fee-for-service) to a value-based payment system. Now is the time for anesthesiologists, as perioperative physicians, to take an active role in shaping future delivery systems and payment models for perioperative care. It is imperative, both for our specialty and for our patients, that anesthesiologists help shape efforts to reengineer perioperative care to achieve better outcomes at lower cost. The U.S. healthcare system is at a cross-road. We can no longer accept the notion that traditional fee-for-service model will lead to the correct incentives for high value care. We can no longer accept the fact that medical errors are the eight leading cause of death in the United States. Anesthesiologists cannot afford to continue to sit on the sidelines of healthcare reform. We need to become not just participants, but leaders in promoting changes that will benefit our patients and our specialty. In this white paper, we describe ongoing federal initiatives to reengineer the healthcare system to lower costs and improve quality, identify some of the challenges and opportunities facing anesthesiology during this transformation, and finally, discuss the need for a partnership between anesthesiologists and surgeons to spearhead the development of patient-centered, team-based performance measures for surgical patients.