Executive Report  |   July 2018
The Transformative Power of the Perioperative Surgical Home
Author Affiliations
  • Paul Pomerantz
    Chief Executive Officer
Article Information
Central and Peripheral Nervous Systems / Education / CPD / Ethics / Medicolegal Issues / Gastrointestinal and Hepatic Systems / Geriatric Anesthesia / Patient Safety / Practice Management / Advocacy and Legislative Issues / Quality Improvement / Executive Report / Opioid
Executive Report   |   July 2018
The Transformative Power of the Perioperative Surgical Home
ASA Monitor 7 2018, Vol.82, 10-11.
ASA Monitor 7 2018, Vol.82, 10-11.
Early in my career, I served as a mid-level executive with an inner-city hospital in Philadelphia that was heavily reliant on capitated payments from Medicaid and commercial managed care plans. We didn’t think of it, but in those days, we were pioneers. My CEO struggled with, then made the transition from, worrying about hospital census to keeping “plan members” out of the hospital and medical loss ratios. We were early adopters of “population-based health” and were living in, out of necessity, an insurance model.
It is interesting how this experience has prepared me for our current health care environment. Recently, I had the opportunity to attend a program from the American College of Health Care Executives titled “Care Continuum from ER to Post Acute: Making the Argument for Partnerships.” The focus was on keeping patients out of the hospital and providing for the most cost-effective post-acute care. Most executives at the conference worked for systems that have approached or passed that inflection point, where lowering resource use and keeping patients healthy are taking precedence over occupancy. Though not a focus, the faculty recognized the importance of managing the surgical patient and pain medicine. However, I did leave with the impression that health executives still have much to learn. This should be mission critical. According to a 2012 Health Care Cost Institute report, perioperative care accounts for approximately 52 percent of hospital costs in the U.S. The Perioperative Surgical Home (PSH) directly addresses this huge piece of spending. Physician anesthesiologists have an excellent opportunity to lead this aspect of health care transformation.
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