Authors: Marchbanks J, et al.
Anesthesia & Analgesia 141(3): e39–e40, September 2025. doi:10.1213/ANE.0000000000007559
This correspondence examines Anthem Blue Cross Blue Shield’s (BCBS) controversial 2024 policy proposal to limit anesthesia reimbursement to the scheduled duration of surgery, excluding induction and emergence. Although maternity cases and patients under 22 were exempt, the policy threatened to underfund essential perioperative care for most patients. Strong opposition led by the American Society of Anesthesiologists (ASA) forced Anthem BCBS to reverse the policy in December 2024 before its planned implementation in February 2025.
The authors highlight the risks such reimbursement restrictions could create, including financial strain on anesthesiologists, documentation pressure, and incentives to expedite or underreport care. These measures would have disproportionately impacted high-risk patients, such as those undergoing longer cardiovascular procedures or patients with higher ASA classifications. The article frames Anthem’s reversal as a victory for patient safety and professional autonomy but warns that similar insurer strategies may reappear.
What You Should Know
• Anthem BCBS proposed limiting reimbursement to surgical time only, excluding induction and emergence.
• ASA advocacy forced a reversal before the February 2025 rollout.
• Such restrictions could compromise anesthesia safety by incentivizing rushed or underreported care.
• High-risk patients requiring longer anesthetics would have been disproportionately affected.
• Ongoing advocacy is critical to prevent future insurer-driven limitations.
Practice Implication: Anesthesia groups should proactively monitor insurer policy changes, coordinate with the ASA, and prepare advocacy strategies to safeguard comprehensive perioperative coverage and prevent unsafe cost-cutting measures.
References
Anthem Blue Cross Blue Shield won’t pay for complete duration of anesthesia. ASA News Release. Accessed March 3, 2025. Link
Steadman J, Catalani B, Sharp C, Cooper L. Trauma Surg Acute Care Open. 2017, 2:e000113. doi:10.1136/tsaco-2017-000113
U.S. Department of Labor. Anesthesia Services and Reimbursement Policy. Accessed December 13, 2024. Link
Serbin B. Trends and Consequences in Health Insurer Consolidation. Center for American Progress. Accessed December 13, 2024. Link
Costa A da S Jr. Einstein (Sao Paulo). 2017, 15:200–205. doi:10.1590/S1679-45082017AO4002
Phan K, Kim JS, Kim JH, et al. Global Spine J. 2017, 7:727–734. doi:10.1177/2192568217701095
Thank you Anesthesia & Analgesia for allowing us to use this article.