AANA Journal: Practice Model Trends in Medicare Payments Across States and Regions-Practice Model Trends in Medicare Payments Across States and Regions

Practice Model Trends in Medicare Payments Across States and Regions

Pdf Summary

A recent study analyzed the use of different anesthesia delivery models in Medicare payments across states and regions in the United States. The study found that there has been a shift towards more efficient certified registered nurse anesthetist (CRNA)-oriented delivery models, with an increasing use of CRNAs in anesthesia delivery. However, this shift has occurred unevenly across states and regions. The study also found that workforce composition and CRNA scope of practice regulations influence the choice of anesthesia delivery models. States with a larger share of CRNAs in the anesthesia workforce were more likely to use care team or undirected CRNA models, while states with a smaller share of CRNAs relied more on physician anesthesiologists practicing alone. The presence of anesthesia assistants (AAs) and the scope of practice regulations for CRNAs also played a role in the choice of delivery models. Additionally, the study highlighted the impact of normative and organizational factors on practice models, which may vary across states and regions. The findings suggest that there is a need for policies that encourage competition among providers and support the adoption of more efficient delivery models in anesthesia care. The study also noted that the COVID-19 pandemic may have further influenced practice models, with the removal of barriers to CRNA scope of practice and the expansion of CRNA roles. The study concludes that understanding the factors driving practice model patterns can inform efforts to improve the cost-effectiveness of anesthesia care.

Keywords

anesthesia delivery models

Medicare payments

United States

certified registered nurse anesthetist

CRNA-oriented delivery models

workforce composition

CRNA scope of practice regulations

care team model

physician anesthesiologists

COVID-19 pandemic