Pass through funds for anesthesiologists

[Man o War]

Congresswoman Lynn Jenkins : Press Releases : Reps. Jenkins and Cleaver Introduce Bill To Expand Access to Rural Anesthesiology Care

Great news for my colleagues who want to work rural if this passes. This would be another blow to the AANA and their attempt to create an unlevel playing field in rural America via pass through funds for nurses only.

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[Consigliere]

No chance of passing.

 

[waterbottle10]

I don't get it. How would this attract docs?

 

[Man o War]

I don't get it. How would this attract docs?

Right now, this pass through money is only available to hospitals for nurse anesthetists. The hospitals have an incentive to hire nurses and a disincentive to hire docs.

 

[Wiscoblue]

Not just to hire. If you were to inquire about getting privileges at a rural hospital the CEO will tell you 'we prefer CRNAs ' and that's because they get this pass through money.


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[aneftp]

Not just to hire. If you were to inquire about getting privileges at a rural hospital the CEO will tell you 'we prefer CRNAs ' and that's because they get this pass through money.


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And they pocket the difference as well. It's easy to pay a solo crna around 275k rural hospital to work 30 hours a week doing 30 operating room cases and maybe another 40 gi cases. Than to pay an MD who may demand more like 325k to work similar.

 

[Noyac]

No chance of passing.

Why?

 

[Mad Jack]

I don't get it. How would this attract docs?

Extra money for the same work, so long as you're willing to work rural.

If this were to pass, I might give anesthesiology a second look, as I'm all about the rural living but there's not enough market for anesthesia in the places I want to call home specifically because of the passthrough rules.

 

[Man o War]

Not just to hire. If you were to inquire about getting privileges at a rural hospital the CEO will tell you 'we prefer CRNAs ' and that's because they get this pass through money.


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Yes I believe @chocomorsel ran into this if I'm remembering right.

 

[Consigliere]

Why?

AANA lobby too strong; physicians too apathetic.

 

[Noyac]

AANA lobby too strong; physicians too apathetic.

I don't think that will be enough to stop it. But we will see.
Has everyone contributed the PAC, Both ASA and state?

 

[AdmiralChz]

AANA lobby too strong; physicians too apathetic.

Eh, this bill doesn't really push out CRNAs just ensures more of a care team model slash solo MD for those areas. Solid bill.

 

[Mman]

Eh, this bill doesn't really push out CRNAs just ensures more of a care team model slash solo MD for those areas. Solid bill.

well sure but the AANA (and hence every nurse in the country) will fight it strongly. It doesn't push them out, but it adds competition for those dollars. As it is now, only CRNAs are eligible. They don't want doctors being eligible.

 

[aneftp]

well sure but the AANA (and hence every nurse in the country) will fight it strongly. It doesn't push them out, but it adds competition for those dollars. As it is now, only CRNAs are eligible. They don't want doctors being eligible.

And AANA and hospitals will use the propaganda saying Anesthesiologist average salary is 340k and crna salary is 160k.

But they specifically avoid what rural solo Crna's make and how little work some do. They will leave about that little details. Hospitals will support crna since they pocket some of the money as well. The rural hospitals and the AANA are in cohoot with each other.

All the public Sees is 340k vs 160k salary.

 

[Man o War]

Last I saw the ASAPAC is funded far better than the nurses PAC.
Besides every time this kind of bill or an AA bill gets introduced, they have to spend resources to buy their no votes.
Keep em coming, I say.

 

[DrCommonSense]

Last I saw the ASAPAC is funded far better than the nurses PAC.
Besides every time this kind of bill or an AA bill gets introduced, they have to spend resources to buy their no votes.
Keep em coming, I say.

Hope so but the CRNAs have been pretty successful so far in getting themselves freed up from physician "oversight"

But the anesthesiologists need to keep fighting or they are going to be screwed.

 

[Mad Jack]

well sure but the AANA (and hence every nurse in the country) will fight it strongly. It doesn't push them out, but it adds competition for those dollars. As it is now, only CRNAs are eligible. They don't want doctors being eligible.

They've fought every similar bill for years, by saying allowing anesthesiologists into the areas would "increase the costs of care" and saying these are jobs anesthesiologists don't want anyway which is total BS and makes zero sense. They just don't want any competition on the rural front.

 

[dmk5n]

I know people think it's the AANA lobby that undermines anesthesiologists. Call me a conspiracy theorist, I think the hospital lobby is one pulling the strings. The hospitals have much more resources to spend, and more to gain by commoditizing the specialty. Look at opensecrets: American Hospital Association-22M in lobbying in 2016. Compared to ASA 1.2 M. (AANA was about 0.89 M). It's no surprise momentum is going where it's going. caveat: Not sure how reliable this site truly is, but its all I got.

Anyhow, I hope the bill passes.

 

[WholeLottaGame7]

They've fought every similar bill for years, by saying allowing anesthesiologists into the areas would "increase the costs of care" and saying these are jobs anesthesiologists don't want anyway which is total BS and makes zero sense. They just don't want any competition on the rural front.

If they really thought they provided equal care for cheaper, they'd be encouraging this legislation to prove their point because it would be a no-brainer. The fact that they fight it is all you need to know about their own honest self-assessment.

 

[Noyac]

I know people think it's the AANA lobby that undermines anesthesiologists. Call me a conspiracy theorist, I think the hospital lobby is one pulling the strings. The hospitals have much more resources to spend, and more to gain by commoditizing the specialty. Look at opensecrets: American Hospital Association-22M in lobbying in 2016. Compared to ASA 1.2 M. (AANA was about 0.89 M). It's no surprise momentum is going where it's going. caveat: Not sure how reliable this site truly is, but its all I got.

Anyhow, I hope the bill passes.

I don't know who you are but you have a keen sense of reality.
Good on you boy (girl).

 

[DrCommonSense]

I know people think it's the AANA lobby that undermines anesthesiologists. Call me a conspiracy theorist, I think the hospital lobby is one pulling the strings. The hospitals have much more resources to spend, and more to gain by commoditizing the specialty. Look at opensecrets: American Hospital Association-22M in lobbying in 2016. Compared to ASA 1.2 M. (AANA was about 0.89 M). It's no surprise momentum is going where it's going. caveat: Not sure how reliable this site truly is, but its all I got.

Anyhow, I hope the bill passes.

Hospital Lobby and Venture Capital/Private Equity groups are strongly pushing it as well. Nurses couldn't do it by themselves.

I have argued this in other posts.

 

[Noyac]

Hospital Lobby and Venture Capital/Private Equity groups are strongly pushing it as well. Nurses couldn't do it by themselves.

I have argued this in other posts.

You make it sound like they are pushing for it. But I believe you mean against it, right?

 

[DrCommonSense]

You make it sound like they are pushing for it. But I believe you mean against it, right?

Pushing for nurse independence. They would probably be against this bill.

 

[Noyac]

Pushing for nurse independence. They would probably be against this bill.

No way. The hospital association is all in on nursing independence.

 

[DrCommonSense]

No way. The hospital association is all in on nursing independence.

I agree. They are for making CRNAs independent of anesthesiologists and flooding the market with a high supply of anesthesia providers to lower costs through lower salaries.

 

[Noyac]

I agree. They are for making CRNAs independent of anesthesiologists and flooding the market with a high supply of anesthesia providers to lower costs through lower salaries.

Not just in anesthesia.

 

[GravelRider]

I know people think it's the AANA lobby that undermines anesthesiologists. Call me a conspiracy theorist, I think the hospital lobby is one pulling the strings. The hospitals have much more resources to spend, and more to gain by commoditizing the specialty. Look at opensecrets: American Hospital Association-22M in lobbying in 2016. Compared to ASA 1.2 M. (AANA was about 0.89 M). It's no surprise momentum is going where it's going. caveat: Not sure how reliable this site truly is, but its all I got.

Anyhow, I hope the bill passes.

I've been saying this for some time now. The American Hospital Association is one of the AANA's biggest allies. The AHA is not our friend in the fight against midlevels.

The conspiracy theorist in me also suspects that the American Hospital Association is responsible for the push to weaken resident work hour limits.

 

[chocomorsel]

Yes I believe @chocomorsel ran into this if I'm remembering right.

Yup. In Texas and NV anyway.

 

[jwk]

They've fought every similar bill for years, by saying allowing anesthesiologists into the areas would "increase the costs of care" and saying these are jobs anesthesiologists don't want anyway which is total BS and makes zero sense. They just don't want any competition on the rural front.

It's not just that they don't want competition - they're scared to death of it. Why do you think CRNAs don't want AAs? It has nothing to do with scope of practice and education or the fact that we're not "nurses first". It's that we represent competition and they are, have been, and will always be scared to death of it.

 

[Victorinox]

Same applies in pain, hospital lobby push for disparity in reimbursement for same procedures.

Same procedure in-office will get 20% of what hospitals get. Also the concept of facility fees seems to be an incentive to pervert the system, which hospitals strongly lobby for. So not surprised they're pushing mid levels.

In rural Midwest, some CRNAs doing pain procedures in small hospitals. Not only is it a clinical concern, you soon realize they can only do this because hospital administration make a ton of money in facility fees off this questionable clinical practice.