Legislation to bolster rural hospitals includes provision to give CRNAs autonomy.
The recent bipartisan Save America’s Rural Hospitals Act includes a provision to permanently remove physician supervision of Certified Registered Nurse Anesthetists (CRNAs), under Medicare Part A conditions of participation.
That provision, along with another to include non-medically directed CRNA services as a mandatory benefit under the Medicaid program, is being cheered by the American Association of Nurse Anesthesiology (AANA).
CRNAs have been practicing without this regulation for nearly three years under healthcare flexibilities issued during the public health emergency.
"Today more than ever, rural communities must address accessibility issues, including a lack of healthcare providers, the needs of an aging population suffering from more chronic conditions, access to healthcare, and larger percentages of uninsured and underinsured citizens," said Angela Mund, DNP, CRNA, president of AANA.
"As a CRNA who grew up in a small town in far northwestern Minnesota, I know firsthand the challenges of recruiting healthcare providers and how important the solo CRNA was to ensuring that we could provide surgical services to our community,” she said.
More than 170 rural hospitals across the country have closed their doors since 2005, and 453 rural hospitals are vulnerable for closure, according to the National Rural Health Association.
"This legislation would permanently end Medicare cuts that have devastated small-town hospitals,” said U.S. Rep. Sam Graves (R-Mo.), who reintroduced the bill along with U.S. Rep. Jared Huffman (D-Calif.), to rescue rural hospitals on the brink of bankruptcy and get them back on solid ground.
"CRNAs are the primary providers of anesthesia care in rural settings and have been instrumental in delivering care during the pandemic to patients where they live and when they need it," said Mund, in encouraging AANA members to contact their local U.S. Representative to support the bill.
"Often, CRNAs serve as the sole anesthesia provider in rural hospitals, affording these facilities the capability to provide many necessary procedures," she said
The importance of CRNA services in rural areas was highlighted in a study that showed that compared with anesthesiologists, CRNAs are more likely to work in areas with lower median incomes and larger populations of citizens who are unemployed, uninsured, and/or Medicaid beneficiaries.
“I know firsthand the challenges of recruiting healthcare providers and how important the solo CRNA was to ensuring that we could provide surgical services to our community.”
— Angela Mund, DNP, CRNA, president, American Association of Nurse Anesthesiology
Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.
CRNAs have practiced without physician supervision for nearly three years during the public health emergency.
CRNAs often serve as the sole anesthesia provider in rural hospitals.
CRNAs are more likely than anesthesiologists to provide care to populations who are unemployed, uninsured, and/or Medicaid beneficiaries.