For Policymakers
The Importance of Physician-Led Anesthesia Care
From the American Society of Anesthesiologists
When you undergo surgery or a procedure, your safety is the top priority. Anesthesiologists are physicians who have extensive medical training to manage anesthesia, pain, and any medical emergency that may arise. Physician-led care ensures that a doctor with broad medical expertise is making complex decisions about your health. While anesthesia teams often include nurse anesthetists and anesthesiologist assistants, the anesthesiologist provides oversight and final responsibility, which improves safety and quality outcomes.
As medical doctors and leaders of the Anesthesia Care Team, anesthesiologists ensure the safest and best outcomes for all patients. That’s why laws in most states and the policies of the nation’s top hospitals require physician-led anesthesia care. Removing anesthesiologists from care raises risks for patients without expanding health care access or reducing costs. Don’t jeopardize your constituents. Preserve physician-led anesthesia care.
Leading care with unmatched expertise
Anesthesiologists value all anesthesia providers and the teamwork that goes into providing patients with the highest-quality care. They evaluate, monitor, and supervise patients before, during, and after surgery and lead the Anesthesia Care Team to ensure optimal patient safety. Nurses and other nonphysician practitioners are trained primarily to administer anesthesia, not to make critical decisions during surgery. Anesthesiologists’ extensive education and training have prepared them to make those crucial choices that can mean the difference between life and death.
Providing high-quality care and reducing costs
Anesthesiologists’ services are reimbursed by Medicare, Medicaid, and most third-party insurers at the same rate as services provided by nurse anesthetists. But anesthesiologists’ involvement and leadership play a critical role in controlling health care costs before, during, and after surgery by:
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Reducing unnecessary testing, same-day cancellations, operating room emergencies, and surgical complications.
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Decreasing the need for additional consults from other specialty physicians for services that could have been provided by an anesthesiologist.
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Reducing the risk of costly hospitalization following outpatient surgery.
Maintaining Physician-Led Anesthesia Care:
Research Supports Value for Hospital and
Health System Outcomes, Cost, and Access
Providing high-quality care and reducing costs
Anesthesiologists’ services are reimbursed by Medicare, Medicaid, and most third-party insurers at the same rate as services provided by nurse anesthetists. But anesthesiologists’ involvement and leadership play a critical role in controlling health care costs before, during, and after surgery by:
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Reducing unnecessary testing, same-day cancellations, operating room emergencies, and surgical complications.
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Decreasing the need for additional consults from other specialty physicians for services that could have been provided by an anesthesiologist.
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Reducing the risk of costly hospitalization following outpatient surgery.
Mitigating those risks is vital. The presence of an anesthesiologist prevented 6.9 deaths in 1,000 cases in which a complication occurred according to an independent analysis of nearly 200,000 Medicare patients who had orthopedic surgery.
Anesthesia Care Team
The Anesthesia Care Team (ACT) is a model of collaboration. An anesthesiologist leads and supervises nurse anesthetists (CRNAs), anesthesiologist assistants (AAs), residents, and students to provide comprehensive anesthesia care. Each team member plays a vital role, but the physician anesthesiologist ensures that all aspects of patient care are coordinated, safe, and tailored to individual needs.
Medical Title Misappropration
Anesthesiologists are medical doctors. Nurses are not. That’s why the use of titles such as “nurse anesthesiologist” is dangerously misleading. Medical title misappropriation removes the transparency in health care that patients deserve—denying them the opportunity to make fully informed choices for themselves and their loved ones.
Keep health care honest. The term “anesthesiologist” has always referred to physicians who are extensively trained in the science and practice of anesthesiology. The American Medical Association, the American Board of Anesthesiology, and the American Board of Medical Specialties affirm that anesthesiology is a medical specialty and that professionals who refer to themselves as “anesthesiologists” must hold a license to practice medicine.
Ways To Protect Your Constituents
Protect your constituents and preserve physician-led care by opposing legislation that removes anesthesiologists from anesthesia care in your state. Take these three easy steps to get started.
Equip yourself with facts and firsthand accounts about the ways in which anesthesiologists ensure patient safety. Learn how anesthesiologists improve patient outcomes, reduce medical costs, and provide access to high-quality health care. Contact us to get in touch with an anesthesiologist in your constituency.
Surprise Medical Billing
“Surprise medical billing” happens when patients receive care at a hospital or surgical center and later get a bill from a provider outside their insurance network. Federal law (the No Surprises Act) now protects patients from most surprise bills, especially for anesthesia services provided at in-network hospitals. In Kentucky, anesthesiologists and their professional societies continue to work with policymakers and insurers to ensure transparency, fair payment practices, and patient protection.
Rural Pass Through - Improve Rural Health Care Access
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Many states, including Kentucky, face ongoing challenges in assuring access to medical care services for their citizens living in rural areas. Insufficient Medicare payments and low patient volume have made it particularly difficult for many rural facilities to attract and retain qualified health care providers. In response to these challenges, Congress has enacted a variety of incentive programs to encourage providers to practice in rural areas. One such program is the anesthesia rural “pass-through” program – a program created as an incentive for anesthesia providers to practice in small rural hospitals.
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Under the “pass-through” program, eligible hospitals may use reasonable-costs based Part A payments in lieu of the conventional Part B payments as a rural practice inducement for non-physician anesthesia providers such as anesthesiologist assistants and nurse anesthetists to practice in small, low volume rural hospitals. Under the Centers for Medicare and Medicaid Services (CMS) current interpretation of the current “pass-through” program, eligible small rural hospitals are not permitted to use the “pass-through” funds to hire physician anesthesiologists. The American Society of Anesthesiologists (ASA), through formal comment, has requested that CMS permit rural hospitals to use the rural pass-through arrangement for physician anesthesiologists, as well as the other providers. However, CMS responded that it cannot permit hospitals to use the pass-through arrangement for physician services.
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Congressman Emanuel Cleaver (D-MO-05) and Congressman Jason Smith (R-MO-08) introduced the bipartisan Medicare Access to Rural Anesthesiology Act which would reform the program and allow rural hospitals to use already available “pass-through” funds to employ or contract with all types of anesthesia providers – physician anesthesiologists, as well as nurse anesthetists and anesthesiologist assistants. We as Kentucky anesthesiologists, along with the ASA, strongly support this legislation.
Extending the pass-through arrangement to physician anesthesiologists allows eligible rural hospitals to utilize the rural incentive payment for all types of anesthesia providers. In rural hospitals, there is an acknowledged shortfall of physician health care providers. By extending the pass-through, rural hospitals could more readily recruit and retain physicians to provide anesthesia services in rural areas.
Eligible Kentucky Hospitals:
COLUMBIA TJ HEALTH COLUMBIA
LIBERTY CASEY COUNTY HOSPITAL
MORGANFIELD DEACONNESS UNION COUNTY HOSPITAL
HARDINSBURG BRECKINRIDGE HEALTH INC
BARBOURVILLE BARBOURVILLE ARH HOSPITAL
HYDEN MARY BRECKINRIDGE HOSPITAL
MARTIN OUR LADY OF THE WAY
MCDOWELL MCDOWELL ARH
MONTICELLO WAYNE COUNTY HOSPITAL
MT VERNON ROCKCASTLE HOSPT. & RESPIR CARE CTR
STANFORD FORT LOGAN HOSPITAL
WEST LIBERTY MORGAN CO. ARH
HARRODSBURG JAMES B HAGGIN MEMORIAL HOSPITAL
Other KY Issues
Kentucky faces unique healthcare challenges:
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Opioid Epidemic: With some of the highest opioid use and overdose rates in the nation, anesthesiologists play a key role in opioid stewardship—helping reduce unnecessary opioid prescriptions and offering safer pain management alternatives.
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Workforce and Training: Kentucky’s medical schools and residency programs are working to train and retain anesthesiologists to meet future patient needs, ensuring that patients have access to safe, physician-led care close to home.
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