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In the U.S., advanced practice providers like Certified Registered Nurse Anesthetists (CRNAs) deliver safe and high-quality care where and when patients need it. 

CRNAs are advanced practice registered nurses (APRNs) who administer more than 50 million anesthetics and pain management services each year in all types of settings across the U.S. As APRNs, CRNAs practice with a high degree of autonomy and professional respect and are qualified to make independent judgments regarding all aspects of anesthesia and pain management care based on their education, licensure, and certification.  

In some states, CRNAs are the sole anesthesia providers in in rural and underserved areas, allowing these medical facilities obstetrical, surgical, trauma stabilization, and pain management capabilities.

In 2010, the provider nondiscrimination provision in the Affordable Care Act was passed to prohibit private health insurance companies from setting different rates for different types of providers who deliver the same high-quality healthcare services. These policies decrease patient access to care and increase healthcare costs.  There is currently no way to enforce this law, despite Congressional direction requiring federal agencies to issue a regulation to implement enforcement of these policies. Until this rule is issued, insurance company policies can jeopardize patients’ access to care.

For many years, CRNAs have received reduced reimbursement rates from insurance plans compared to other providers for giving the same types of services. Recently, insurers have announced new cuts that must either be absorbed by healthcare facilities or passed on to patients. The effects of this will be felt nationwide.

Without an enforceable rule, many APRNs, including CRNAs continue to face barriers to providing care, based on these discriminatory policies from insurers.

These inconsistent insurance reimbursement practices are compromising patients’ access to care and causing cost-shifting that impacts medical professionals, facilities and patients. Patients deserve to have their choice of providers who provide high-quality, evidence-based care, especially to those living in rural and underserved areas.

Access to Care is at Risk

By the Numbers

• CRNAs administer more than 50 million anesthetics and pain management services each year to patients in the U.S.
  
  
• CRNAs have a minimum of 7 to 8 ½ calendar years of education and experience specific to nursing and anesthesia before they are licensed to practice anesthesia.
  
  
• In some states, CRNAs are the sole anesthesia providers in nearly 100 percent of rural hospitals, affording these medical facilities obstetrical, surgical, trauma stabilization, and pain management capabilities.
  
  
• Since 2010, 136 rural hospitals have closed, with more than 180 and counting closed since 2005, and this trend will continue.
  
  
• According to a 2021 peer-reviewed study there is an estimated 10.7% excess demand for anesthesia services, meaning that the labor market for anesthesia providers is short by over 9,000 providers.
  
  
• CRNAs are Medicare Part B providers and since 1989, have billed Medicare directly for 100 percent of the physician fee schedule amount for services.

Insurance company policies can jeopardize patients’ access to care