Greetings SCSA! The ASA completed it’s annual year end on September 30th and I wanted to provide a summary of the activities over the past year.

The ASA strategic plan is made up of 6 strategic pillars. Advocacy, Quality and Practice Management, Educational Resources, Member Growth and Experience, Health Systems Leadership, and Scientific Discovery, and an additional category of Organizational Excellence. The First 6 are the main categories of activity for the organization, and the last one is how we look at our ASA, its functions, and its future growth and change to meet future challenges.

Advocacy–  The ASA has continued to engage administration agencies, congress, and other stakeholders in such topics as drug shortages, opioid crisis, Balance billing ( Out of Network), preserving physician access in the VA system, Dental sedation and Anesthesia, Nurse Anesthesiologist labels, and the ASA Perioperative Brain health Initiative. We have worked hand in hand with other physician groups on these issues as well as participated with summits, roundtables, and federal work groups on these issues. Other areas we are putting our support behind is Resident debt relief, and we have created a new ad hoc committee on “Medicare for All” to assist in educating policymakers and legislators as to why this would be a very bad thing for the profession of Anesthesiology. Another area that my own committee is working on is creating resident education in Advocacy so we can teach the next generations how vital this is to our profession.

Quality and Practice Management– The ASA has made it a priority to develop strategies to build a consensus on appropriate physician-led anesthesia practice models and related payment policies. Many economic pressures are building on some practices pushing for the supervision of greater than 4:1 and using QZ billing. The hard restriction of being able to supervise only 4 rooms can create problems for practices but at the same time allowing too many rooms to be covered lowers the quality of the care delivered, impacts your ability to adequately provide that care, and quite frankly is unethical at times. The current push for a ‘rescue anesthesia’ model is antithetical to all that we stand for in the Patient Safety arena and so look for the ASA to come out with guidelines on this over the next 2 to 3 years.  Progress is also being made on demonstration of value and economic development of the Anesthesia Quality Institute (AQI). Most notably, new Centers for Medicare and Medicaid Services guidelines favor society-based registries and are creating collaborative and revenue opportunities, including with large national groups. At this writing AQI revenues are such that we anticipate a positive variance of $450,000. Further activities include implementation of new fee schedule, continuing recruitment of new practices, implementation of a new private payer quality reporting initiative and an arrangement with ePreop for lower cost data warehousing services.

Educational Resources– SimSTAT Module 4 has been completed and we are close to completing module 5 of SimSTAT, and sales, especially pre-sales of the full set, have been strong. Staff met with our development partner, CAE, in May and have agreed to focus 2020 on international distribution and to exploring mobile applications. So far, one such distribution agreement, with the European Society of Anaesthesiology, has been implemented. The ASA is on target in working with Wolters Kluwer on the business plan and launch by mid-2020 the newly revitalized Monitor. ASA continues to be the leading source of CME for all Anesthesiologists.

Membership Growth and Experience– The ASA has spent a tremendous amount of time and effort in the area of membership. Computer-aided clinical decision support tools are on the horizon and every attempt to create app based platforms and seamless/frictionless online engagement is a high priority (although a very expensive one!) Staff is working to develop state component benchmarks to help identify best practices so states can learn from one another and these templates and practices will be shared with all the component societies… especially the small ones who do not have a lot of resources.  The career center has been reworked and launched to provide for job hunting by ASA members, and this past year we joined up with SoFI to offer special rates for student loan financing for membership. Membership is showing about a 2 percent year to year growth , however it is estimated that we only have approximately 70% of all Anesthesiologists as members. That means 30% of docs are riding on your dues paying coattails!

Health Systems Leadership– ASA’s joint programs in leadership continue to move forward. An ASA-American College of Healthcare Executives Masterclass will be offered in conjunction with ANESTHESIOLOGY® 2019. Also, joint programs are being piloted at the component level. Finally, registration for the basic Kellogg program is live, and the program is expected to be fully subscribed as it always has. The advanced Kellogg program registration launched in the second week of June. Regarding residency resources, we are in discussions with a couple entities to adopt and expand our learning technology and portfolio of programs. Other current initiatives are to refine leadership development pathways to members at different stages of their careers: aspiring, mid-career and transformational/C-suite, to provide career development leadership resources including mentoring, and to develop education and resources to proactively prepare Physician Anesthesiologists to assume positions of authority in health systems (e.g., C30suite), state and national medical societies, and elected office.

Scientific Discovery-This is our newest pillar and it is dedicated to developing strategies for scientific discovery, including identification of trends/forces/factors, through the end of 2020. It is to include appropriate stakeholders in development efforts and should include the large number of our members in private practices. This pillar also seeks to increase funding for anesthesia research related to targeted populations (such as the Brain Health Initiative) and to seek higher funding through NIH for anesthesiology related research. Substantial momentum has developed between ASA, FAER and IARS representatives to create an Anesthesiology Research Collaborative, which held its inaugural research summit July 12-13 in Schaumburg.

Organizational Excellence– January marked a full year as Chief Operating Officer for Brian Reilly. This move has strengthened accountability and improved coordination across member-facing services and associated technologies. During this period, we have assessed our communications functions (which we are currently preparing for our 2020 communications project!) and now have Marketing, Publications and Digital Content, and Public Relations under a single executive, Maureen Geoghegan, who joined ASA from the American Academy of Orthopaedic Surgeons. Chris Wehking assumed strategic leadership for the Meetings and Exhibits Department (replacing Danielle Urbina) while also retaining his role for business and relationship development as Associations and Business Relations Executive andwe recently announced the appointment of Susan Carlson as Chief Learning Officer. DeLaine Schmitz has been promoted to Quality Services Executive. In this role, she will continue to lead the Anesthesia Quality Institute (AQI) and supervise Quality and Regulatory Affairs. She will also provide administrative direction to the methodologist team supporting the Committee on Standards and Analytic Services and to Analytics and Research Services. (this is the science behind our Standards/Guidelines/and Statements). I include this information as these are the parts of the underbelly of our organization that you will never see or hear about in our newsletters or journal. These are the incredible people that run the nuts and bolts of the ASA.

Your ASA is continually engaged on your behalf, and if you have any questions or concerns please reach out to me. All the best to all of you!