Economic Impact, Cost, and Reimbursement Issues

  • Deepti Agarwal
  • Maunak V. Rana


Healthcare delivery costs in the perioperative setting have increased due to varying factors. Regional anesthesia (RA) minimizes costs and would lead to cost benefits on evaluation. RA allows for airway avoidance and minimizes/eliminates general anesthesia requirements for perioperative patient care. Additionally, patients receiving RA have fewer effects from perioperative anesthetic agents than their general anesthesia cohorts.

Bypassing Phase I recovery leads to tangible savings that medical center leadership may tangibly notice. Older patients and those with comorbidities are able to have surgery on an outpatient basis, largely on the strengths of RA, leading to a fiscally viable healthcare delivery.

With the implementation of programs to enhance care and recovery via protocol-driven algorithms (ERAS and ERPs), RA plays a vital role in virtually all surgical encounters, enabling cost beneficial and safe patient care.

The anesthesiologists of today and tomorrow will play a vital role in the perioperative home and in executing the ERAS programs via a RA service. Fiscal responsibility is reflected by perioperative physician’s technical choices in care delivery. This cost-saving approach also allows for new avenues and revenue for the anesthesia service team. Key considerations are required in the implementation of a RA service and in the documentation of procedures performed for economic viability.

Armed with an analysis of evaluating the plethora of techniques and agents to provide safe and cost-effective care, the anesthesiologist with regional expertise and insight into the economics of healthcare will be poised to lead the operating room of tomorrow.


Regional anesthesia Anesthesia-controlled times (ACT) Economics Peripheral nerve block Billing Ultrasound guidance Operating room management Fixed and variable costs Performance standards Perioperative efficiency 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of AnesthesiologyAdvocate Illinois Masonic Medical CenterChicagoUSA
  2. 2.Department of Anesthesiology and Critical CareThe University of ChicagoChicagoUSA

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