Update of Cost Effectiveness of Anesthesia Providers
The Lewin Group conducted a study for the American Association of Nurse Anesthetists. We examined the cost effectiveness of the different anesthesia delivery models in use in the United States today, including Certified Registered Nurse Anesthetists (CRNAs) acting solo, physician anesthesiologists acting solo, and various models in which a single anesthesiologist directs or supervises one to six CRNAs.
A cost simulation model developed in Hogan et al. (2010) is used to evaluate both differences across delivery models. A stochastic simulation model simulates likely costs and revenues associated with each delivery model, holding constant other conditions likely to affect costs and revenues in the comparisons, i.e. demand, characteristics of the procedure, and payer. The simulation model highlights recent updates to the parameters used in the model. A summary of the cost and revenue implications of different delivery model types are examined and compared.
The information presented can help inform payers and employers (e.g., hospitals, anesthesia provider groups, public and private insurers) regarding the cost, quality, and access implications of alternate delivery models. The findings provide an evidence base to inform federal and state regulators and legislators who are formulating rules and regulations regarding the delivery of anesthesia. Further, information from this study can help federal and state legislators, education program directors, and other stakeholders regarding the potential return on investment from investing in anesthesia education and improving access to quality, cost-effective anesthesia care.
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