We read with great interest the recent Special Article by Mahajan et al., who pointed out the anesthesiologists’ role in value-based perioperative care during the COVID-19 pandemic and the subsequent financial implications facing hospitals. Anesthesiologists should serve as clinical leaders to drive healthcare transformation across the perioperative process, to implement integrated standardized pathways with the goal to improve outcomes, and to manage costs as healthcare systems transition toward value-based care. While we appreciate the notion of the anesthesiologist as a leader, we believe the focus on directly providing anesthetic care misses the opportunity to further develop and implement clinical pathways for procedures, which can be safely performed without the direct presence of an anesthesiologist.

The authors cite an article by Toppen et al., who stratified patients to undergo transcatheter aortic valve replacement with either...

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