Client Overview
A medium-sized, independent Anesthesia group providing services across multiple hospital and ambulatory surgery center (ASC) facilities on the Pacific Coast of the United States.
Group Profile
- 40+ anesthesiologists and CRNAs
- Servicing 10 facilities (hospitals and ASCs)
- Mix of urban and suburban markets
- Facing tightening margins, rising staffing costs, and inconsistent financial performance across locations
The Challenge
The Anesthesia group faced mounting pressure to maintain consistent staffing and service levels across all facilities while managing reimbursement compression stemming from federal payer rate reductions and commercial payer cost-control efforts impacting anesthesia providers, rising provider compensation expectations, and operational cost variability.
Key concerns included:
- Uneven profitability across facilities
- Lack of granular financial data to support stipend negotiations
- No clear visibility into per-facility expenses or staffing needs
- Inability to present a cohesive business case to facility administrators
The Solution:
Anesthesia-Specific RCM & Financial Analysis Support
Our RCM team partnered closely with the group’s leadership to implement a comprehensive facility-by-facility financial analysis. Key deliverables included:
1. Detailed Facility-Level Profitability Reporting
- Built a detailed report breaking down cases, charges, collections, and expenses for each service location, with roll-ups for facilities that operate under the same site of service type.
- Included line-item breakdowns such as MD and CRNA salaries, direct expenses, indirect expenses and overhead allocations
- Identified loss-leading locations and the operational drivers behind them
2. Stipend Negotiation Support
- Equipped group leadership with actionable data to approach hospital administrators
- Created presentation-ready financial summaries tailored for non-clinical stakeholders
- Demonstrated the need for stipends and revenue guarantees in facilities where costs outpaced collections
3. Staffing Ratio Optimization
- Correlated case volume with provider hours and call burden at each site
- Delivered facility-specific staffing recommendations based on coverage needs and margin thresholds
- Supported the group in strategically allocating CRNA and physician resources while ensuring compliance and high-quality care
4. Revenue Forecasting and Guarantee Modeling
- Modeled revenue and stipend needs under various volume and payer mix scenarios
- Supported creation of guaranteed minimum revenue agreements for critical access and underperforming facilities
- Developed contingency models for volume drops and staffing fluctuations
The Results
As a result of the RCM company’s anesthesia-specific expertise and data-driven approach, the Anesthesia group achieved several key wins:
Outcome: Stipend Agreements Secured
Impact: Secured enhanced stipends in facilities requiring supplemental funding to support operations.
Outcome: Improved Profitability Transparency
Impact: Enabled leadership to track performance monthly by location
Outcome: Sustainable Staffing Ratios
Impact: Reduced unnecessary shifts and overtime, improving cost structure
Outcome: Revenue Guarantees Established
Impact: Secured minimum monthly revenue commitments at key facilities
Outcome: Group Stability Preserved
Impact: Avoided potential service terminations or staff layoffs
Conclusion
This case underscores the importance of anesthesia-specific RCM support that goes beyond billing. With deep operational insight and financial acumen, RCM services can play a pivotal role in helping independent groups stay profitable, negotiate fairly, and provide uninterrupted patient care, even in today’s challenging healthcare environment.