As anesthesia reimbursements continue to sink, many leaders are concerned about the potential ripple effects on patients, physicians and ASCs.
Brian Cross, CRNA, owner of Youngstown, Ohio-based CS Anesthesia, joined Becker's to discuss the long-term implications of anesthesia reimbursement cuts and the biggest misconception about anesthesia billing.
Question: Could you characterize the long-term implications of anesthesia cuts trends on patients?
Brian Cross: Long-term, I can see anesthesia groups going out of network and charging patients directly. In the next five to 10 years, large groups may exit insurance networks altogether. They’d bill patients, who would then have to fight to get reimbursed by their insurers. It’s not unlikely.
There’s going to be a breaking point for smaller companies like mine. I hire [certified registered nurse anesthetists] to work for me, but the costs are almost too high to justify keeping contracts with surgery centers. These centers are going to have to increase their volume to stay viable. Right now, CRNAs and anesthesiologists expect to be paid for an eight-hour day, but if the surgery center finishes in six hours, that’s lost revenue. Unless things change, this entire system will likely hit a breaking point within five years.
Q: What would you say is the biggest misconception about anesthesia billing?
BC: The biggest misconception is that we get paid lots and lots of money, especially because, in most realms, from Medicare, you're getting about 30 to 35% of what we would typically get from private insurance companies. It's kind of bizarre how, in our world, every year we could be doing the same amount of cases, everything, same number of centers that we're billing, and we keep getting less and less and less. And I don't think the payers are taking pay cuts, to be honest.