Anesthesiologists to CMS: ‘We want to be valued’

Anesthesiology faces numerous pressure points, including provider shortages and decreasing reimbursements. And, as private payers typically look to Medicare to determine their reimbursement rates, some look to CMS to change the course of consistent rate declines.

Here is what four anesthesiologists told Becker’s they would like to see from CMS: 

Editor’s note: Responses have been lightly edited for clarity and length. 

Mark Destache, MD. Anesthesiologist with Associated Anesthesiologists, P.A. (Plymouth, Minn.): What anesthesiologists want from CMS is a fair wage for taking care of this patient population. The conversion factor for anesthesia has been cut by a third since 1992 when not adjusted for inflation. It is currently $20.77 per 15 minutes, which is the same whether it is open heart surgery or cataracts. That is less than what CRNA wages are, so in effect, the anesthesiologist makes less than nothing once the case is going.

Christian Welch, MD. Anesthesiologist at UT Health San Antonio: In short, we want to be valued. Despite an ever-increasing percentage of patients on Medicare, which typically represents an older and sicker patient population, our profession is taxed with annual cuts. The 2025 proposed anesthesia conversion factor is $20.33, down from $20.43 in 2024 and $20.67 in 2023. Commercial insurers typically follow CMS reductions. In addition, we are taking care of more ASA 3 and sometimes ASA 4 patients in ASCs. Anesthesia has become very safe, mostly due to the work of the Anesthesia Patient Safety Foundation. That does not mean, however, that our role as perioperative physicians and “guardians” of the OR should be taken for granted.

Donald Keusch, MD. Anesthesiologist at Boca Raton (Fla.) Plastic Surgery Center: Anesthesiologists would like fair reimbursement for their services. Currently, Medicare pays 28% of the anesthesia rate that is received from commercial insurance. This is intolerable and is not sustainable. Rather than increasing reimbursement over the years to account for inflation, there has been a further absolute decline in payments to physicians. The situation for Medicaid is even worse.

Javier Marull, MD. Associate Professor in the Department of Anesthesiology and Pain Management at UT Southwestern Medical Center (Dallas): As anesthesiologists, what we really want is to give our patients the best care possible without getting bogged down in unnecessary red tape. We are with our patients through every step of their journey, not just in the operating room, and we would love to see that dedication reflected in fair compensation. 

A big part of the challenge we face is the amount of time spent on paperwork and approvals, which takes us away from what really matters: our patients! If CMS could simplify these processes, it would make a huge difference, allowing us to focus more on patient care and less on administrative tasks. At the heart of it all, we just want to do what we are trained to do, care for people without the constant barriers that make that harder than it should be