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AANA urges Medicare to consider hospital anesthesiology efficiency measures

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You are reading page 4 of AANA urges Medicare to consider hospital anesthesiology efficiency measures. If you want to start from the beginning Go to First Page.

Agreed. After spending years in the Army. I can say the care provided is top notch. Much, much better even when comparing small meddacs to small hospitals. Really no comparison at all.

*** I take issue with this. The absolute finest health care organization I ever worked for and was a patient of were army hospitals. I choose to receive my care at the VA, even though I have Cadillac health insurance through my employer. I choose the VA for one simple reason, they provide GREAT care. At least the one I go to does.

The Best Care Anywhere - Phillip Longman

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*** I take issue with this. The absolute finest health care organization I ever worked for and was a patient of were army hospitals. I choose to receive my care at the VA, even though I have Cadillac health insurance through my employer. I choose the VA for one simple reason, they provide GREAT care. At least the one I go to does.

The Best Care Anywhere - Phillip Longman

I have a family member that died in a VA hospital and I saw the poor care he received.

I have a family member that receives almost all his medical care from the VA. Marginal at best.

I did clinical rotations at a VA hospital and saw the quality of care delivered. Sorry - been there - seen it - and I wouldn't wish it on my worst enemy. If it's all you got, it's better than nothing.

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I have a family member that died in a VA hospital and I saw the poor care he received.

I have a family member that receives almost all his medical care from the VA. Marginal at best.

I did clinical rotations at a VA hospital and saw the quality of care delivered. Sorry - been there - seen it - and I wouldn't wish it on my worst enemy. If it's all you got, it's better than nothing.

*** I wonder how old your experiences are. I too had a horrific experience as a patient in the VA 15 years ago. They have changed a lot. However even if we disregard the VA there is the matter of publicly owned active duty hospitals that are top rate.

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I have a family member that died in a VA hospital and I saw the poor care he received.

I have a family member that receives almost all his medical care from the VA. Marginal at best.

I did clinical rotations at a VA hospital and saw the quality of care delivered. Sorry - been there - seen it - and I wouldn't wish it on my worst enemy. If it's all you got, it's better than nothing.

JWK, I totally agree with you on this with the exception of the D.C. VA all the VAs I have worked at or with I think the care is well below marginal.

I blame the VA for the death of my father last year.

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IMHO you need to be well informed self advocate to get good care through the VA.

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JWK, I totally agree with you on this with the exception of the D.C. VA all the VAs I have worked at or with I think the care is well below marginal.

I blame the VA for the death of my father last year.

*** I have quite a bit of experience with the Minneapolis VA, both as a nurse and a patient, and as the main clinical site for many of my CRNA friend. IMO they deliver fantastic care and there is very little to complain about.

I did quite a bit of work for them when they decided to implement a full time RRT RN position. I got to spend time and see patients every unit in the large hospital. I was impressed and since then have received all my health care there. I had heard great things about it from several friends who had attended their CRNA program.

They treat their nurses well and pay them very well.

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And of course nobody speaks to the content of Janice's letter - although I can guess of course how most CRNA's would feel.

Not EVERY anesthesia group receives a stipend for providing services. Many don't get a dime. It varies from location to location within a region, state, or even in cities or a different side of town. And there's always someone who will do it for less, which is one of the biggest problems with anesthesia management companies. That's when quality of patient care starts to become secondary to financial considerations.

CRNA's in critical access hospitals already essentially get a stipend as well that's not available to anesthesiologists via the Medicare Part A "pass-through".

And let's remember that there are plenty of CRNA-only groups that receive stipends for providing coverage as well, just like the all-MD or ACT groups. But hey, for those who get stipends, I don't begrudge them that compensation. Providing 24/7 coverage, especially in low-volume hospitals, is always a problem.

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM7896.pdf

I stumbled upon this earlier today and I know it's a little out of date, it refers to rural and critical access hospitals receiving "pass-through" payments for CRNA services from Medicare. I just wanted to ask a CRNA about what this means. Is it the stipend you're referring to? How does it affect reimbursement?

Can any CRNA please clarify what this change for pass-through payments to hospitals mean?

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I can tell you that the Feds make it so difficult to get the pass thru that is has been a non issue at the two rural hospitals I practiced in.. Something to do with all the call and cms not wanting to cover it so they denie the pass thru. One hospital appealed it up the chain and was overruled at the top.

They bite the bullet and don't get pass through funds.

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*** I wonder how old your experiences are. I too had a horrific experience as a patient in the VA 15 years ago. They have changed a lot. However even if we disregard the VA there is the matter of publicly owned active duty hospitals that are top rate.

Indeed, the VA now as a whole is vastly improved from its past.

They say, if you've seen one VA, you've seen one VA.

There are still the good and the bad just as there are with privates.

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I can tell you that the Feds make it so difficult to get the pass thru that is has been a non issue at the two rural hospitals I practiced in.. Something to do with all the call and cms not wanting to cover it so they denie the pass thru. One hospital appealed it up the chain and was overruled at the top.

They bite the bullet and don't get pass through funds.

So in theory it's supposed to give CRNAs a stipend (extra $$$) to work at critical access hospitals or rural hospitals?

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No, medicare is supposed to reimburse the HOSPITAL for part of the cost of having a CRNA at the hospital. Nothing extra. CRNA gets normal salary. Hospital gets part of it reimbursed depending on how many medicare patients they treat.

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I can tell you that the Feds make it so difficult to get the pass thru that is has been a non issue at the two rural hospitals I practiced in.. Something to do with all the call and cms not wanting to cover it so they denie the pass thru. One hospital appealed it up the chain and was overruled at the top.

They bite the bullet and don't get pass through funds.

If that was true everywhere, the AANA wouldn't be fighting so hard to keep it and to bar anesthesiologists from getting it.

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