Articles  |   June 2014
Outpatient/Short-Stay Vascular Surgery: A Model for the PSH
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Ambulatory Anesthesia / Cardiovascular Anesthesia / Articles
Articles   |   June 2014
Outpatient/Short-Stay Vascular Surgery: A Model for the PSH
ASA Monitor 06 2014, Vol.78, 30-31.
ASA Monitor 06 2014, Vol.78, 30-31.
What is the Perioperative Surgical Home (PSH), and are both anesthesiologists and surgeons ready to accept this? The PSH is a concept of coordinated perioperative patient care that has been proposed by physician anesthesiologists. In a recent paper from Vetter et al. from the University of Alabama-Birmingham, the benefits and aspects of the surgical home were well described.1  It has been proposed by ASA and others as “an innovative, patient-centered, surgical continuity of care model that incorporates shared decision making.”1  The need for this is multifaceted. One of the goals of the Affordable Care Act is to reduce costs and improve health care outcomes by shifting the system toward quality over quantity through increased competition, regulation and incentives to streamline the delivery of health care. These goals will be accomplished by moving from a fee-for-service payment plan to “value-based purchasing.” That “value” will be determined by various outcomes measures, including patient-reported outcomes, complications and metrics such as length of stay, 30-day readmission, mortality and surgical site infections. Furthermore, the Centers for Medicare & Medicaid Services (CMS) reduced all hospital payments by 1 percent in 2013, and will be reducing these payments by an additional 0.25 percent per year through 2017. Hospitals may earn back the reductions with incentive programs based on quality metrics.
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