A Buffalo, N.Y.-based ASC stopped performing pediatric surgery after its anesthesiology group left and the center moved to a CRNA-only model. Before that, it had been one of only two local sites performing pediatric strabismus surgery.
Kimberly Fullone, administrator of Niagara Falls, N.Y.-based Ambulatory Surgery Center of Niagara, told Becker’s the change hurt the center’s case volume and the community’s access to care.
“It was bad for the whole community,” she said.
Ms. Fullone said the center’s anesthesia group pulled out roughly two years ago because payer reimbursement no longer made the contract worthwhile.
The center couldn’t find a replacement. She said local groups had two reasons for passing. First, low-paying eye cases are less attractive than hospital work or larger surgical cases. Second, staffing shortages have made groups pickier about the centers they take on. The U.S. is projected to face a shortage of 6,300 anesthesiologists by 2036 and roughly 12,500 CRNAs by 2033, and nearly 57% of practicing anesthesiologists are 55 or older.
“Before, all these companies would have loved to pick up other surgery centers, but now they’re getting more selective,” she said. “They don’t have the manpower to pick up other centers.”
The center turned to a CRNA-based group. Under that model, its surgeons became responsible for supervising anesthesia, a role Ms. Fullone said they weren’t trained for and didn’t want.
The center’s strabismus surgeon wasn’t comfortable supervising anesthesia for children in an outpatient setting. Ms. Fullone stressed that his concern was about the surgeons’ own readiness, not the CRNAs’ skill.The surgeon now does his pediatric strabismus cases at another facility that has an anesthesiologist on staff, one day a week or one day a month.
Ms. Fullone said the inconvenience means he performs fewer of them, and the center now has to be more selective about which cases it takes
“We love CRNAs,” she said. “It’s not that we don’t have faith in them, we just want to make sure we are in the best position in the event of an emergency.”
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
