Better Access, Lower Costs


Access to Safe Anesthesia Act puts Michigan patients first

Changing Michigan’s outdated anesthesia model will give hospitals and health care facilities the flexibility needed to:

  • Safely meet patient needs in underserved rural and urban communities.
  • End the turf war between what’s best for patients and taxpayers
  • Help lower costs and out-of-pocket expenses for safe anesthesia
  • Align Michigan’s anesthesia model with 42 other states (and the District of Columbia)

Certified registered nurse anesthetists (CRNAs) are some of the highest-educated medical professionals. With bipartisan House Bill 4359, Michigan has the opportunity to do what 42 other states (and the District of Columbia) in the nation have done to improve access to safe anesthetic care.

  • Michigan's current anesthesia regulations are antiquated — from the dark ages — and anti-patient. Michigan is now among only eight states that continue to require mandatory supervision of CRNAs by physicians.
  • 42 other states (and the District of Columbia) do not have mandatory supervision requirements and unnecessary restrictions on CRNAs.
  • Since federal rules were approved in 2001, a growing list of states have 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 health care quality. To the contrary, studies have found improved access to needed anesthesia services in the opt-out states, evidence of lower health care costs, and no differences in medical outcome.

The Access to Safe Anesthesia Act makes permanent in Michigan a bipartisan CRNA regulatory model put in place during the early weeks of the COVID-19 pandemic by Gov. Gretchen Whitmer and other Democratic and Republican governors, and in alignment with policy from the Trump Administration.

  • After COVID-19 hit Michigan patients and hospitals in the worst public health crisis in 100 years, Gov. Whitmer temporarily suspended Michigan’s unnecessary supervision requirement for CRNAs – and some 2,600 CRNAs answered the call.
  • Practicing independently and without unnecessary “supervision,” Michigan CRNAs delivered safe and effective care to patients across Michigan during the toughest months of the COVID-19 crisis.

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 a meaningless government mandate that drives costs higher and limits access to safe anesthesia services in underserved rural and urban Michigan communities.

Based on experiences in other states, there is evidence House Bill 4359 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 that patient safety is protected in CRNA regulatory models similar to the one in House Bill 4359.

  • Peer-reviewed medical research finds no differences in patient safety and surgical outcomes in states with and without the meaningless CRNA supervision model that would end in Michigan under House Bill 4359.
  • 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.
  • Only one special interest group benefits from Michigan’s CRNA supervision mandate: Physician anesthesiologists gain from the red tape in the current system at the expense of patients and hospitals, especially in rural Michigan.