An Evaluation of Commercial Payer Reimbursement and Contracting Factors for Physician Anesthesiologists and Certified Registered Nurse Anesthetists for Services Performed in 2019.
Study Performed by:
Jean Covillo, DNAP, MA, CRNA
Maria Sallie Poepsel, PhD, CRNA, APRN, FAANA
Jeanie Skibiski, DNAP, MHA, CRNA, CPPS, FAANA
The authors sought to establish commercial rate benchmarks specific to CRNA anesthesia delivery models, quantify any payer disparities discovered between CRNAs and anesthesiologists, and determine payer alignment with nondiscrimination provisions of the Affordable Care Act.
“The commercial insurance industry is benefiting, rather than Hospitals, Surgery Centers, and Anesthesia groups from cost-effective strategies when utilizing CRNA services.
The results of this research will be instrumental in reversing that dynamic, ensuring hospitals, surgery centers, patients, and anesthesia groups become the beneficiaries of savings generated as a result of these strategies rather than the payers themselves. The recommendations provided in this study would reduce or eliminate subsidies paid to anesthesia groups by Hospitals and Surgery Centers for shortfalls in anesthesia collections when contracting for services.”~Jean Covillo, DNAP, CRNA, Managing Member, Excel Anesthesia, LLC