AANA Statement on BCBS Reimbursement Policy Changes

Rosemont, Ill.  (AANA)—The American Association of Nurse Anesthesiology (AANA) issued the following statement, attributable to AANA President Dru Riddle, PhD, DNP, CRNA, FAAN, in response to the announcement that Blue Cross Blue Shield (BCBS) plans will no longer reimburse anesthesia providers based on patient care complexity:

This week, AANA was informed of a change in anesthesia reimbursement policy from the insurance company Blue Cross Blue Shield (BCBS). Effective June 1, BCBS plans in Texas, Illinois, Montana, New Mexico and Oklahoma will no longer provide additional payment for physical status modifiers.

Physical status modifiers have been in use for decades. These modifiers are used to assess and communicate a patient’s pre-anesthesia medical co-morbidities and can be helpful in predicting perioperative risks.

Such payment policies can impede patients’ access to care. For example, anesthesia providers like Certified Registered Nurse Anesthetists (CRNAs) rely on physical status modifiers to help ensure the highest level of safety during patient care. Not considering the complexity of patient care undervalues anesthesia services.

Policies such as those introduced by BCBS can cause providers to leave an insurance network, move to a different state, or in extreme cases, leave the healthcare system. This leads to decreased access to anesthesia care for patients and can be especially felt in rural areas with smaller provider pools but where CRNAs predominate.

Without CRNAs to administer anesthesia and pain management services in rural and underserved areas, where many of BCBS’s members reside, patients would lose access to vital treatment, which could result in poor healthcare outcomes, lower quality of life, and unnecessary costs to patients.

AANA is vehemently opposed to this change.  If you have been contacted by another BCBS state affiliate or another payer regarding these policy changes, please contact us at info@aanadc.com.

AANA is requesting that BCBS rescind these policies. As health plans still discriminate against providers based on licensure, such policies impact CRNAs even more profoundly.