Medicare reimbursements for anesthesia are declining, and with a rising provider shortage and increasing demand, many leaders are concerned about how these factors will affect patient care.
“Anesthesia used to be a seemingly unlimited commodity,” Jeff Dottl, principal at Ventura, Calif.-based Physicians Surgery Centers, told Becker’s. “They were lucky to be invited to work at your surgery center. The tables have turned, and now if centers have anyone to cover anesthesia, it usually comes at a hefty price.”
Medicare reimbursements decreased from $22.2730 per unit in 2019 to $21.1249 in 2023, according to a June report from VMG Health. Providers were further affected by the No Surprises Act and its independent dispute resolution process — payers are using the process to “reduce their required reimbursement by refusing to go in network with the anesthesia providers,” according to the report.
Because of this, VMG Health has received an increasingly high number of requested subsidy arrangements for ASCs, according to the report.
VMG suggests hospitals and other ASCs partner with their anesthesia group and advocate for in-network contracts.
Some leaders are worried this trend could affect the migration of procedures to the outpatient setting.
“The shift of inpatient to outpatient cases is a given, but this trend may be slowed by the abysmal Medicare reimbursement for anesthesia cases,” Andrew Lovewell, CEO at Columbia (Mo.) Orthopaedic Group, told Becker’s. “When salaries, wages and benefits are higher for an outpatient total joint than the anesthesia reimbursement, we have a problem. This is a double-edged sword as the case migration needs to happen to save Medicare money on the facility side, but they [Medicare] have to step up the anesthesia reimbursement if this is going to work.”