Anesthesia Provider Pay to Drop 60%

Specialties CRNA

Published

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

Specializes in OR, CV ICU, IMCU.

I am about to start CRNA school and am not deterred by the prospect of pay cuts. I enjoyed working in the OR and felt that I had more to contribute to the care of patients in surgery. That's one of the main reasons I wanted to persue this career and being payed well for it is a bonus. :nurse:

CRNAs can and do practice independently in every state. Opt out has only to do with billing independently for Medicare/Medicaid patients. There are no laws in any state that I know of that doesn't allow for CRNAs to practice independently.

42CFR (civil federal regulations) 485.639 - Condition of participation: Surgical services

(2) In those cases in which a CRNA administers the anesthesia, the anesthetist must be under the supervision of the operating practitioner except as provided in paragraph (e) of this section. An anesthesiologist's assistant who administers anesthesia must be under the supervision of an anesthesiologist.

(e) Standard: State exemption. (1) A CAH may be exempted from the requirement for physician supervision of CRNAs as described in paragraph ©(2) of this section, if the State in which the CAH is located submits a letter to CMS signed by the Governor, following consultation with the State's Boards of Medicine and Nursing, requesting exemption from physician supervision for CRNAs. The letter from the Governor must attest that he or she has consulted with the State Boards of Medicine and Nursing about issues related to access to and the quality of anesthesia services in the State and has concluded that it is in the best interests of the State's citizens to opt-out of the current physician supervision requirement, and that the opt-out is consistent with State law.

Specializes in Anesthesia.
42CFR (civil federal regulations) 485.639 - Condition of participation: Surgical services

(2) In those cases in which a CRNA administers the anesthesia, the anesthetist must be under the supervision of the operating practitioner except as provided in paragraph (e) of this section. An anesthesiologist's assistant who administers anesthesia must be under the supervision of an anesthesiologist.

(e) Standard: State exemption. (1) A CAH may be exempted from the requirement for physician supervision of CRNAs as described in paragraph ©(2) of this section, if the State in which the CAH is located submits a letter to CMS signed by the Governor, following consultation with the State's Boards of Medicine and Nursing, requesting exemption from physician supervision for CRNAs. The letter from the Governor must attest that he or she has consulted with the State Boards of Medicine and Nursing about issues related to access to and the quality of anesthesia services in the State and has concluded that it is in the best interests of the State's citizens to opt-out of the current physician supervision requirement, and that the opt-out is consistent with State law.

This deals with billing for CMS services. There is not a federal law that deals with supervision of CRNAs. Scope of practice issues are dealt with on the state level.

You can call it whatever you want, but the practical aspect is that CRNAs in every state suffer no more supervision than the operating practitioner requesting anesthesia. There is a big difference between meeting a legal/billing definition for "supervision" and actual supervision.

Wow, so this FEDERAL LAW has absolutely nothing to do with supervision as it states, only billing, which it says nothing about. So this LAW actually means that it is giving people permission to BILL for supervision without actually having to supervise? Call me crazy, but *I* believe the law says what it says and means exactly what it says. I will have to call my congressman in DC and get back to you... No wonder health care is so expensive. Billing for supervision when there isn't a supervisor is not right. Having a law which clearly states that CRNA's must be supervised but is merely a billing tool is bizarre in my mind.

$150k - 60% = $60,000, $200k - 60% = $80,000, the average salary for a registered nurse in san francisco, ca is 80k, I don't see how this can be true, unless the government plans to lower registered nurse salary aswell, not only does a CRNA have to obtain a bsn they also obtain a masters while going for CRNA, all of this extra education to make less or equal to what they would be making with a asn as a registered nurse? I don't think I can buy into it, CRNA's are not doctors but they administer anesthesia just the same, if a MDA was making lets say $300k and they lowerd his salary 60% to $120k how many of those doctors do you think would stay MDA's? I doubt not that many which would make the demand higher and salary to go back to what they already are. right? am I missing something? :uhoh3:

Specializes in Anesthesia.
Wow, so this FEDERAL LAW has absolutely nothing to do with supervision as it states, only billing, which it says nothing about. So this LAW actually means that it is giving people permission to BILL for supervision without actually having to supervise? Call me crazy, but *I* believe the law says what it says and means exactly what it says. I will have to call my congressman in DC and get back to you... No wonder health care is so expensive. Billing for supervision when there isn't a supervisor is not right. Having a law which clearly states that CRNA's must be supervised but is merely a billing tool is bizarre in my mind.

This is a federal regulation not a law, and you really don't understand the topic your trying to discuss. You might try looking on AANA - Home

and doing a search on supervision and opt-out to get a better understanding of the term "supervision" as it is used by CMS.

Never again is some strange person who has posted on at least one other board (a mistreated patient on topix) either they have some real emotional issues or are chronically resistant to knowledge eg regulation vs law. pay no nevah mind.

Specializes in CVICU, Trauma ICU, ER and EMS.

if you look at anesthesia in terms of mda's making 300k+ a year, after a 50% pay cut that would still put them ahead of crna's making 135k a year on average. what this whole initiative tells me is that mda/doa's salaries are too high in the governments mind and they would like see more parity in pay for what they alleady see as parity in work.

my fear is that other anesthesia providers will be financially hurt by the this same initiative, the aa’s and crna. i think it's sad that other practitioners of anesthesia could potentially be on the receiving end of salary cuts also, but you never know...

Interesting article, however the public option was dropped from the final House bill, and is projected to have no chance in the Senate.

Meaning? SO you think anesthesia will receive a pay cut?

I think I will listen to the AANA one of the most powerful anesthesia organizations in the country which is not predicting a cut in pay or a dramatic increase in private insurance rates. You may want to look a some neutral assessments on healthcare before spouting pure speculations on here. http://moneywatch.bnet.com/economic-news/article/health-care-reform-summary-who-wins-and-who-loses/406279/

THanks wtbcrna for the AANA links. I am with you on that, I believe the AANA over most of these other articles. You stated that the AANA predicts no pay cut for CRNAs. Where does it say in the AANA link?

I sure didn't vote for Obama. I am amazed at home many health care providers did.

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