Allowing certified registered nurses to administer anesthesia without direct supervision from a physician did not increase risks to patients in the 14 states where governors allowed healthcare providers to bill the CMS for such cases, a study has found.
Little risk in nurse anesthetists working solo: study
The study, published in Health Affairs, comes as advanced practice nurses of all stripes are speaking out about the need to expand their scopes of practice in areas with physician shortages, particularly rural areas. The American Medical Association has pushed back just as hard, arguing that allowing clinicians with less medical and scientific training to expand their scopes of practice will put patients in jeopardy.
In the case of certified registered nurse anesthetists, the CMS had long required nurses to have physician supervision during surgery cases in order to qualify for payments. In 2001, it allowed state governors to opt out of that requirement, and 14 did so, mainly in the West and Midwest.
Researchers looked at Medicare claims data from 1999 to 2005, and found no difference in rates of mortality or complications between states where nurses worked alone and where they worked on teams that included physician supervision. The authors recommended CMS drop the requirement that a governor sign off on the new billing rules for unsupervised nurse anesthetists, based on the conclusion that their patients were no more at risk.
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