November Marks 10-Year Anniversary of Landmark Decision
Ensuring New Mexico Residents Access to Safe, Cost-Effective Anesthesia Care
2002 removal of physician supervision of nurse anesthetists strongly supported by recent studies
Park Ridge, Illinois— Ten years ago this month New Mexico became the sixth state to opt out of the federal physician supervision requirement for Certified Registered Nurse Anesthetists (CRNAs). The landmark decision by then-Governor Gary Johnson, which was supported by the New Mexico Association of Nurse Anesthetists (NMANA) ensured New Mexico citizens access to safe, cost-effective anesthesia care, particularly in rural and other medically underserved areas of the state.
In November 2002, less than two years after the Centers for Medicare & Medicaid Services (CMS) published its anesthesia care rule granting state governors the ability to opt out of the supervision requirement, Gov. Johnson sent a letter to CMS informing the agency that “it is in the best interest of the State’s citizens to exercise this exemption.” Johnson is currently the 2012 Libertarians presidential nominee
“This was a great decision for the residents of New Mexico 10 years ago, and continues to be today. The opt-out insured that patients throughout the state have access to the anesthesia care they need,” said
NMANA President Christian Felt, CRNA. “In New Mexico, CRNAs have long provided the majority of the anesthesia care to patients of all ages, for all types of procedures, and in every setting in which anesthesia care is delivered.”
Two recent studies have confirmed that Gov. Johnson showed tremendous foresight in opting out of the physician supervision requirement. The study titled “No Harm Found When Nurse Anesthetists Work Without Supervision by Physicians,” conducted by RTI International and published in the August 2010 issue of Health Affairs, examined nearly 500,000 individual cases involving anesthesia and confirmed what previous studies have shown: CRNAs provide safe, high-quality care that is the same with or without physician supervision.
The other study, titled “Cost Effectiveness Analysis of Anesthesia Providers,” was conducted by Virginia-based The Lewin Group and published in the May/June 2010 issue of the Journal of Nursing Economic$. This study considered the different anesthesia delivery models in use in the United States today, and showed that CRNAs acting as the sole anesthesia provider cost 25 percent less than the second lowest cost model. On the other end of the cost scale, the model in which one anesthesiologist supervises one CRNA is the least cost efficient model. The researchers also confirmed that there is no research to indicate that CRNAs and physician anesthesiologists aren’t equally safe providers.
The results of the Lewin study were particularly compelling for people living in rural and other areas of the United States where anesthesiologists often choose not to practice for economic reasons. The safe, cost-effective anesthesia care provided by nurse anesthetists has been a mainstay in these areas for more than 100 years, ensuring millions of patients access to surgical, obstetrical, trauma stabilization, and pain management procedures.
Since 2001, 17 states have opted out of the federal physician supervision requirement for nurse anesthetists: Iowa, Nebraska, Idaho, Minnesota, New Hampshire, New Mexico, Kansas, North Dakota, Washington, Alaska, Oregon, Montana, South Dakota, Wisconsin, California, Colorado, and Kentucky.
About the American Association of Nurse Anesthetists