While demand for anesthesia services has skyrocketed, Medicare reimbursements have shrunk, according to VMG Health's 2023 "Physician Alignment: Tips & Trends" report.
Here are five notes on the decline of anesthesia reimbursements:
1. Medicare reimbursements for anesthesia services decreased from $22.2730 per unit in 2019 to $21.1249 in 2023 under CMS' final rule.
2. The No Surprises Act and its independent dispute resolution process have created further obstacles to secure anesthesia reimbursements. The act has "led to unintended consequences for anesthesia providers," and the IDR process has been used by payers to "reduce reimbursement by refusing to go in network with anesthesia providers," according to the report.
3. The decline in reimbursements had led to an increase in provider staffing costs, according to the report, and compensation for CRNAs and anesthesiologists has increased in the last year.
4. "The confluence of decreased federal and commercial reimbursement amid increased compensation associated with staffing anesthesia providers is challenging independent anesthesiology groups and health system/ASC partners alike," the report added.
5. ASC leaders are feeling the pressure of the anesthesia shortage and increase in costs.
"The shift of inpatient to outpatient cases is a given, but this trend may be slowed by the abysmal Medicare reimbursement for anesthesia cases," Andrew Lovewell, CEO at Columbia (Mo.) Orthopaedic Group, told Becker's. "When salaries, wages and benefits are higher for an outpatient total joint than the anesthesia reimbursement, we have a problem. This is a double-edged sword as the case migration needs to happen to save Medicare money on the facility side, but they [Medicare] have to step up the anesthesia reimbursement if this is going to work."