jwk

jwk

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All Content by jwk

  1. AANA urges Medicare to consider hospital anesthesiology efficiency measures

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    Some anesthesiologists clearly work in rural areas, and a majority of CRNA's tend to work in urban centers as well. Using your own statistics... If 70% of anesthetics in rural areas are provided by...

  2. AANA urges Medicare to consider hospital anesthesiology efficiency measures

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    I dunno - why do the majority of CRNA's work in large urban areas? Maybe it's because higher population density = higher need for anesthesia provider. Of course I don't have a study to back that up...

  3. AANA urges Medicare to consider hospital anesthesiology efficiency measures

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    I have a perfect understanding of pass-through and how it works. The law does in fact apply to AA's - I didn't write it - I'm just telling you what is in it in case you weren't quite clear. Clearly...

  4. Day in the life of a CRNA?

    jwk replied to firefly101's topic in Student Registered Nurse Anesthetist

    That's strictly a hospital issue. Plenty of hospitals allow observers - how do you think all those volunteers get in the door? Our hospital actually has some very simple credentialling requirements...

  5. AANA urges Medicare to consider hospital anesthesiology efficiency measures

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    So you're denying that the AANA works to keep the rural pass-through as-is, and seeks to prevent any changes that would allow anesthesiologists to benefit from Part A payment like CRNA's? Just trying...

  6. AANA urges Medicare to consider hospital anesthesiology efficiency measures

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

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

  7. "Anesthesiologists are gaming the system"

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    Do you think payors care what your costs are? They only care about what you charge them. You're trying to convince us that CRNA's are cheaper - cheaper to WHOM? It's not the payor, and that's what...

  8. "Anesthesiologists are gaming the system"

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    Nice try - the charge to the patient is the same. The cost to the practice doesn't matter. And you know as well as I do that the playing field isn't level for rural hospitals that are able to use...

  9. AANA urges Medicare to consider hospital anesthesiology efficiency measures

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    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...

  10. "Anesthesiologists are gaming the system"

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    The costs to the PRACTICE is different - the cost to the payor is the same. When you try and claim that CRNA's are the cheapest alternative for something like Medicare, it's simply not true. Y'all...

  11. "Anesthesiologists are gaming the system"

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    You guys are still dodging the issue. If we want to use a doc and 4 anesthetists to do 4 cases, that's fine. We're not going to be paid any more by the insurance company than we would if it was 4...

  12. "Anesthesiologists are gaming the system"

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    I'm not talking about profit. That's for the hospital/group/practice to determine. It is not the function of Medicare or private insurors to determine the profit to a group or hospital. If the...

  13. "Anesthesiologists are gaming the system"

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    Your own article proves my point. Revenues (what the payor actually pays) are the same, whether done by MD only, CRNA only, or an ACT group. I think in our area, a Medicare unit is about $17. If...

  14. AANA urges Medicare to consider hospital anesthesiology efficiency measures

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    It's common sense. At a certain point, cheaper can't be better. Look at the care provided in government-run hospitals now, both at the federal, state, and local level. Those patients that have a...

  15. "Anesthesiologists are gaming the system"

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    The AHA doesn't support it because some hospitals would prefer to employ CRNA's so they can bill for them and keep a share of the professional fee. The difference in an ACT practice is that same fee...

  16. "Anesthesiologists are gaming the system"

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    No surgeon = no anesthesia - pretty simple

  17. "Anesthesiologists are gaming the system"

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    But a LOT of places won't hire them without anesthesiologists. If they exist at all, hospitals routinely doing big cases - and I mean open heart, major vascular, major peds, major neuro - are going...

  18. AANA urges Medicare to consider hospital anesthesiology efficiency measures

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    And that was my point - cheaper isn't always better. My group doesn't take stipends. Others do, including all-CRNA groups. I don't begrudge them that money for a second. If 24/7 coverage is...

  19. "Anesthesiologists are gaming the system"

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    Just so everyone is clear, this is from an opinion blog from The Hill. It would be much like posting an item on a forum such as allnurses.com. It is NOT a fact-based article or a piece of...

  20. CMS reimbursement rules for AAs

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    I present a different opinion - that's not being trollish. Unfortunately, the MD / CRNA / AA debate will continue to rage on for the forseeable future. My viewpoint, and whether you agree with me or...

  21. AANA urges Medicare to consider hospital anesthesiology efficiency measures

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    As I've pointed out frequently, AA's were not created as a method of control. Please try to remember that a majority of CRNA's practice in ACT practices, and that those practicing independently are...

  22. AANA urges Medicare to consider hospital anesthesiology efficiency measures

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    This is of course your goal. There is no altruistic "lets save our poor government a few bucks" concept going on here. It's dollars and competition plain and simple. You want it all and don't want...

  23. CMS reimbursement rules for AAs

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    Again, there are exceptions built in to the rule to deal with

  24. CMS reimbursement rules for AAs

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    Again - your comment was "the vast majority of anesthesia cases do not meet TEFRA requirements" That comment is not supported by the study you just quoted. The editorial comment Journal...

  25. AANA urges Medicare to consider hospital anesthesiology efficiency measures

    jwk replied to wtbcrna's topic in Certified Registered Nurse Anesthetist, CRNA

    Don't ya just hate it when facts get in the way of