Better Access, Lower Costs

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Smart, Safe Anesthesia Regulations Mean Better Access, Lower Cost

Changing the model will increase access to needed health care services, containing costs, and giving Michigan hospitals the flexibility to meet patient needs in under-served rural and urban communities alike.

  • This effective and proven model would not end physician supervision of Certified Registered Nurse Anesthetists (CRNAs) in Michigan. Instead, it would allow hospitals to choose whether or not to require supervision based on their own staffing, patient and resource circumstances and needs.
  • This effective and proven model will end an outdated and meaningless professional practice mandate that drives costs higher and limits access to anesthesia services in underserved rural and urban Michigan communities.

Changing the model would put patients first, ahead of an out-dated anesthesia model that favors turf wars over what is best for patients and taxpayers. It would put Michigan’s anesthesia model in line with 40 other states.

  • Michigan's current anesthesia regulations are antequated — from the dark ages and anti-patient. Michigan is now among only 10 states that continue to require mandatory supervision of CRNAs by physicians.
  • Forty other states do not have mandatory supervision requirements and unnecessary restrictions on CRNAs.
  • Since federal rules were approved in 2001, a growing list of states has moved to opt-out of federal supervision requirements. Many states have never required physician supervision of CRNAs.
  • Medical studies examining states that do not have supervision requirements found no differences in patient safety or healthcare quality. To the contrary, studies have found improved access to needed anesthesia services in the opt-out states, evidence of lower healthcare costs, and no differences in medical outcome.

At a time when health care laws and delivery are changing, creating a smart, safe anesthesia model in Michigan would improve access to needed, often life-saving, medical care for thousands of patients at Michigan hospitals.

  • More than 325,000 Michigan residents now have health insurance for the first time under the state’s Medicaid expansion. Many of these patients will need surgery.
  • They are entering a health care system where access to surgical procedures is already limited by unnecessary restrictions on anesthesia providers.
  • Michigan has more than 2,000 CRNAs. Already they are the largest providers of anesthesia services in many parts of rural Michigan, allowing patients in these underserved areas to access obstetrical, surgical, and trauma stabilization services.
  • As more people gain health insurance and seek surgeries at their local hospitals, CRNAs can safely and at lower costs provide anesthesia within the scope of their practice.
  • A safe, smart anesthesia delivery model will enable many Michigan hospitals to meet the increased need for surgeries from a growing number of insured patients in the future.
  • A smart, safe anesthesia delivery model will give hospitals the flexibility to administer anesthesia at lower costs, in underserved Michigan communities while protecting health care quality and medical outcomes.

A smart, safe anesthesia delivery model will increase access to needed health care services, containing costs, and giving Michigan hospitals the flexibility to meet patient needs in underserved rural and urban communities alike.

  • A new model would not end physician supervision of CRNAs in Michigan. Instead, it would allow hospitals to choose whether or not to require supervision based on their own staffing, patient and resource circumstances and needs.
  • A new model will end an outdate and meaningless professional practice mandate that drives costs higher and limits access to anesthesia services in underserved rural and urban Michigan communities.

Based on experiences in other states, there is evidence this bill will contain, and even lower, health care costs related to anesthesia and surgeries.

  • A June 2010 Lewin Group study published in The Journal of Nursing Economics found that anesthesia delivery models in which CRNAs administer anesthesia without supervision cost about 25 percent less than the second lowest-cost model.
    • The study concluded: “These results support the conclusion that the most cost-effective delivery model is CRNAs practicing independently.”
    • “Analysis of claims data suggests CRNAs acting independently are the lower cost to the private payer.”
    • “As the demand for health care continues to grow, increasing the number of CRNAs, and permitting them to practice in the most efficient delivery model, will be a key to containing costs while maintaining quality care.”

Substantial scientific and medical research has found no differences in patient safety and surgical outcomes in states with and without CRNA supervision.

  • Studies — including one from the Institute of Medicine, and one from the Research Triangle Institute in 2010 — have found no difference in patient safety or medical outcomes in states that require supervision of CRNAs and states that do not.