Key result
State 'opt-out' of physician supervision for nurse anesthetists was associated with smaller growth in anesthesia utilization rates compared with non-'opt-out' states, suggesting no increase in access.
Why the study?
Does state 'opt-out' of physician supervision requirements increase access to anesthesia care for Medicare beneficiaries?
Cohort
Yes
Does state 'opt-out' of physician supervision requirements increase access to anesthesia care for Medicare beneficiaries?
State opt-out of physician supervision for nurse anesthetists did not increase access to anesthesia care for Medicare beneficiaries.
Opt-out policies warrant caution for expanding access; challenges policy rationale and leaves open effects on care delivery.
In the United States, anesthesia care can be provided by anesthesiologists or nurse anesthetists. Since 2001, 17 states have exercised their right to "opt-out" of the federal requirement that a physician supervise the administration of anesthesia by a nurse anesthetist, with the majority citing increased access to anesthesia care as the rationale for their decision. By using Medicare data, we found that most (4 of 5) cohorts of "opt-out" states likely experienced smaller growth in anesthesia utilization rates compared with non-"opt-out" states, suggesting that opt-out was not associated with an increase in access to anesthesia care.
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Sun et al. (2016) conducted a cohort in Anesthesia services for Medicare beneficiaries. State 'opt-out' of federal requirement for physician supervision of nurse anesthetists vs. Non-'opt-out' states was evaluated on Growth in anesthesia utilization rates. State 'opt-out' of physician supervision for nurse anesthetists was associated with smaller growth in anesthesia utilization rates compared with non-'opt-out' states, suggesting no increase in access.
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