Anesthesia Provider Pay to Drop 60%

[Screen name]

http://online.wsj.com/article/SB10001424052970204683204574358281875211014.html

Incredibly, Congress's proposed health-care reform plan risks skimping on anesthesia. According to one of the health-care bills in Congress, H.R. 3200, the public option would reduce reimbursement for anesthesia by over 50%.

How do you think Healthcare Reform is going to effect the field of anesthesia?

From another blog:

I am shocked that no one is commenting on the potential impact of President Obama's Healthcare reform. As many of you may be aware, under the current proposals, payment of Anesthesiolgists and CRNAs will be a Medicare rates which are about 30% the level of private insurance. My state Anesthesiologist association projects that the bottom-line affect for most anesthesiologists will be a 50% cut in reimbursement. It is a foregone conclusion that in order to compete with the government option, private insurers will drop their reimbursement to the same levels as government.

Now Mr. Orzak, President Obama's budget director, states that there will be further 20% cuts in physician reimbursement in the future. This means that an Anesthesiologists or CRNAs income will be cut 60%.

Don't know if this is still active, but this tries to exempt anesthesia from the reform rates. All anesthesia providers can sign...

http://www.theanesthesiablog.com/2009/10/health-care-reform-updated-daily-well.html

[Rhone]

I'm not sure why there's some much money in anesthesia to begin with, but it's moot because the public option was dropped from the health care bill months ago. Those posted articles are out-dated.

[aura_of_laura]

A salary of $180,000 cut to $100,000? That's really tough. That's still plenty to live comfortably on.

(not to mention they're just trying to scare off healthcare reform with those numbers)

I have no problem with that possible pay cut - especially if the savings will help lower the cost of healthcare. I'd even take a pay cut myself if I thought it would effectively reduce healthcare costs (unfortunately, my pay cut went to pay for my parent-company's poor business decisions, not my patient's care).

[RN543]

What I would like to see now is how many nursing students that will still want to be a nurse if CRNA pay is cut by 50-60%. It seems that 90% of all the other students I encounter all say the same thing, "I'm going to be a CRNA."

Well I for one still want to be a CRNA one day. Money was never the motivating factor for me. However, I'm sure if this happens, then some people will be turned away from the profession. Better for me... less competition to get into anesthesia school lol :)

[fyrace]

Including all of the legal challenges by the States and individuals, and testing the constitutionality over it. Long road ahead either direction.

[Screen name]

Interesting though... I fail to see how this would save money overall. If CRNA's avg income is 150k that would drop the pay down to 60k on avg. Additionally, that would drop anesthesiolgist down to about 135k on avg. I think that there would be a lot less people banging at the doors to do either if this were the case. Who would put themselves through that much more school, hard work, time, sacrifice, and take on more debt to make less money than if you don't. You think people are complaining now. Wait until someone needs an operation and things revert back to the days of a shot of whiskey and a stick in the mouth, because there are no qualified professionals to care for the pt. just my 2cents. : )

The average salary of an Anesthesiologist in the UK is $150,000 (converted from GBP of course), per Google search "Anesthesiologist salary in UK". So, your quoted "135K" is not that far off base for "universal" healthcare systems. That being said I can see CRNA salaries falling into the 60-80,000 pay range. Not all CRNA's make $150,000 - or even $100,000.

As much as physicians are already complaining about Nurse Anesthetists getting paid more when the proposed 20-25% pay cut for MDs takes effect, you can guarantee the CRNA, NP, PA, and Midwife will soon follow.

CRNA's, Anesthesiologists, and Anesthetic drug costs all go hand-in-hand. The government is not looking at your "education and responsibility" one bears on their shoulders; the government looks at, "What? You make... how much?... That's too much. We'll fix that for you. We have to keep cost down, you know?"

[wtbcrna, MSN, DNP, CRNA]

A salary of $180,000 cut to $100,000? That's really tough. That's still plenty to live comfortably on.

(not to mention they're just trying to scare off healthcare reform with those numbers)

I have no problem with that possible pay cut - especially if the savings will help lower the cost of healthcare. I'd even take a pay cut myself if I thought it would effectively reduce healthcare costs (unfortunately, my pay cut went to pay for my parent-company's poor business decisions, not my patient's care).

Interesting math: 60% pay cut from 180K would make the salary 72K not 100K.

[BULLYDAWGRN, RN]

There is going to be a pay cut. 20% or 50% who really knows but one will happen. They are already reducing medicare reimbursements to what 21%. With the new proposed plan they are going to additionally reduce govt reimbursements by some 500 billion. Now you cannot tell me that when the hospital bean counters feel this crunch they are not going to to cut staff, bennifits and salaries from the janitor on up.

[paindoc]

Its about time!

[Screen name]

Interesting math: 60% pay cut from 180K would make the salary 72K not 100K.

Let's please try to keep ******* matches to a minimum. Stay as professional as possible.

I'm wanting to know how HR 3590 is going to effect anesthesia in all aspects, not just pay, but also jobs, security, our costs, etc.

We have fought so long and hard to be "doctor-like" (for lack of a better word) are we now going to say, "Oh no, we're not anything like Anesthesiologists, we're just nurses...." in a last ditch effort to buy our time and pay, benefits, and flexibility?

Edit for paindoc: We are all in this together. It doesn't matter if you are an APN, or a specialist MD, as stated everyone from the janitor to the cardiovascular surgeon will take a hit. If you are an Anesthesiologist you will be hurt as much as we are. Get ready to sell the boat, because no one is going to be able to buy it after November.

I believe this is part of the issue also, we are not all on the same page... even within anesthesia. It's going to be "every man for himself" more so than previously. CRNA's and MD's are about to clash worse than ever.. and paindoc's post proves it.

[wtbcrna, MSN, DNP, CRNA]

Let's please try to keep ******* matches to a minimum. Stay as professional as possible.

I'm wanting to know how HR 3590 is going to effect anesthesia in all aspects, not just pay, but also jobs, security, our costs, etc.

We have fought so long and hard to be "doctor-like" (for lack of a better word) are we now going to say, "Oh no, we're not anything like Anesthesiologists, we're just nurses...." in a last ditch effort to buy our time and pay, benefits, and flexibility?

Ok...your profile says you are a nursing student so what have fought so long and hard for in the CRNA profession?

This is from the AANA whom by the way are not predicting pay cuts for CRNAs.

House Passes Major Health Reform Package; Part Awaits President's Signature into Law, Remainder with Fixes Goes to Senate for Further Work

Late Sunday evening (March 21), the U.S. House of Representatives passed the Patient Protection and Affordable Care Act (HR 3590), clearing comprehensive health reform legislation that the Senate passed Christmas Eve for the President's signature into law, and moving to the Senate a separate package of fixes (HR 4872 and its Managers Amendment) to remedy contentious provisions of the larger bill. The AANA had expressed detailed views on the health reform package in a March 17 letter and stated its support with the unanimous backing of the AANA Board of Directors March 19 (letters require AANA member login and password). More than 2,000 CRNAdvocacy contacts to Capitol Hill were made on CRNA issues during the House's final days of consideration.

"For CRNAs, the adoption of health reform will bring into the insurance and reimbursement system millions of patients whose CRNA services are currently unpaid and unreimbursed," said AANA President Jim Walker, CRNA, DNP. "The bill also advances patient access to CRNA care through a provider nondiscrimination provision that strengthens our negotiation power with health plans for anesthesia services. All of this is a milestone, not the end of the line. In three major ways, the AANA and CRNAs must continue work to advance patient access to CRNA services -- through advocacy before agencies in the health reform implementation process, through advocacy in Congress by promoting critical legislation that the health reform package did not include, and of course through continued excellence in our clinical practice and professional education."

For CRNAs, the major health reform bill includes provisions that the AANA sought and secured, some of which come after a decade and a half of work, and all of which are described extensively on AANA's health reform site for AANA members.

- The bill includes provider nondiscrimination provisions championed by the Patients Access to Responsible Care Alliance (PARCA) coalition of healthcare professionals chaired by AANA. An element of Patients Bill of Rights work in the 1990s, the provider nondiscrimination language gives CRNAs a helpful new tool in negotiating participation with health plans, and is intended to help advance and protect patient access to CRNA services.

- The bill also contains nurse and CRNA workforce development provisions backed by the AANA and the Nursing Community, including a long-overdue reauthorization of Title 8 nurse workforce development programs, the elimination of a statutory 10 percent cap on the share of traineeships funding allocable to doctoral-level education, and a four-year $200 million Graduate Nursing Education (GNE) initiative intended to support APRN workforce development. The GNE initiative also had the support of the AARP, with which the AANA worked closely to secure its adoption.

- The legislation also extends health coverage to tens of millions of Americans who, if they came to CRNAs' operating rooms today, would not be able to pay anything for CRNA services. Current trends indicate climbing health insurance premiums, and increasing growth in the number of uninsured persons, both of which put CRNA services and reimbursement at risk. Under the bill, they would have coverage and CRNA services would be reimbursed instead of unpaid. Further, persons with health coverage would have the benefit of additional consumer protections such as not having their insurance or their actual healthcare denied on account of preexisting conditions, again helping to increase the likelihood that CRNA care is reimbursed instead of left unpaid.

The House votes were mainly along party lines, [a] on moving the Senate-passed bill to the President, on a GOP procedural motion regarding an agreement on federal funds for abortions, and [c] on passage of a package of fixes to send to the Senate for final action. Organizations joining the AANA in supporting the final bill include the American Hospital Association (AHA), American Medical Association (AMA), American Nurses Association (ANA), and the Federation of American Hospitals (FAH). Opponents included the American Society of Anesthesiologists (ASA) which cited the AANA-backed provider nondiscrimination provisions as a justification for its opposition, the Medical Group Management Association (MGMA), and several surgical specialty organizations.

The President is scheduled to sign the big health reform bill (HR 3590) into law during a ceremony on Tue., March 23. Thereafter, the U.S. Senate is expected to take up the package of legislative fixes (HR 4872). If the Senate changes that package in any way, upon the Senate's adoption it will return to the House of Representatives for one more vote before it is shipped to the President to be signed into law. Implementation of the comprehensive health reform legislation, including the development of proposed regulations and other policy changes, begins immediately in the U.S. Department of Health and Human Services (HHS) and several federal agencies.

One particularly urgent issue for CRNAs and physicians remains to be addressed by Congress: reversing the 21.2 percent Medicare Part B payment cuts slated to take effect April 1, 2010. The Senate has adopted a fix effective through September 30, and the House has cleared a fix through April 30. Once either chamber clears the other's fix, the bill can be sent to President Obama to be signed into law.

In addition, because the health reform package also did not include a fix to restore Medicare Part A rural hospital anesthesia services on-call payment to CRNAs, the AANA continues working to promote rural patient access to safe anesthesia care. Legislation pending in Congress, the Rural Access to Nurse Anesthesia Services Act (HR 3151 / S 1585), would restore full reasonable-cost pass-through funding to rural and critical access hospitals for CRNAs' on-call services, and restore funding for rural hospitals whose home counties have lost their rural designation even though the affected hospitals clearly remain in rural areas.

[BULLYDAWGRN, RN]

hey paindoc is gonna start feeling it when 21% medicare kicks in. The mda's in a group will feel it to, cause a fair amount of their buisness (elderly) are going to be on this plan & a good number of their patients will switch to obama care. The mdas that are hospital employees will find that the hospital will be looking at their pay stubs as well. Dont say it wont happen, all employees at my hospital didnt get bonuses this yr except the 4 mda's that work there. Once the onstaff radiologists and er docs found out they raised cain, and administration was faced with eitheir paying all bonuses or taking them away. Well when times are tough they take it away, and they did. Now we got a bunch of ****** mda's, but they are not going no where. Believe me they know whats just around the corner too.

[Screen name]

Good post, wtbcrna. Edited mine so you wouldn't feel so imitated by a lowly "student" (not that it should matter too much). I'm quoted for reference anywho.