In 2024, several major payers have considered changing reimbursements for anesthesia even more, from planning to put time limits on surgeries to getting rid of certain modifiers.
Ronald Harter, MD, professor of anesthesiology at The Ohio State University Wexner Medical Center in Columbus and past president of the America Society of Anesthesiologists, spoke with Becker’s about ASA’s key focuses and pressures in 2025.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What main initiatives are you working on at ASA right now?
Dr. Ronald Harter: We continue to focus on the ongoing challenges from commercial payers, who continue to create challenges for payment for our services, whether its removing modifiers or the proposed change by Anthem to totally reconstruct how anesthesia time is calculated and paid, which fortunately, because of public outcry, they walked back. Those types of challenges continue and that continues to be a focus of ASA and will remain so for a while.
Q: What are some of the most pressing issues in anesthesia in 2025?
RH: Commercial payment is a big challenge, and we are finding that anesthesiology groups of all sizes are really threatened by that, but especially smaller groups that don’t have the reserves or administrative reach to be able to constantly meet challenges from commercial payers. Also, the No Surprises Act implementation; we still are aware of instances where payers are not paying the appropriate payment even after arbitration. All this is just tying up and making challenges for anesthesia drops. On top of that is cutting Medicare payments, that hopefully Congress will be able to come up with not only a patch to remove reduced payment for the current year but also to add in an inflation adjuster so there is an ability for payment or physician services to keep up with costs of providing care. Medicare hasn’t had any substantial increase in the last few decades to come anywhere close to keeping up with inflation. It creates more and more of a gap for all physician specialists, being able to provide care to Medicare recipients at anywhere close to the cost of what it takes to provide care.
Q: What else do you want to expand on?
RH: I will always throw in that all of these challenges that anesthesiologists face are contributors to burnout. That has impacts on the workforce, which also contributes to burnout, so this is more than just about the balance sheet. It impacts the health and well-being of anesthesiologists. We’re also attentive to the wellness of our members and we provide resources for them, but that’s really just a small part of the solution. There needs to be better compensation for the care we provide from both commercial and government payers to help alleviate the crushing burden of burnout that colleagues are facing.
