On November 1, 2022, the Centers for Medicare & Medicaid
(CMS) announced the final rule for the 2023 anesthesia conversion factor (CF) of
$20.6097 vs. the current rate for 2022 of $21.5623. This will result in an
overall decrease of 4.42 percent in reimbursement for anesthesia services in the
upcoming year. The CF reduction will not only affect provider reimbursements but
also affect facility O.R. contribution margins.
The overall impact will vary as the CF rates are based on
geographical location. Nevertheless, this reduction may negatively impact
providers. The President of the American Society of Anesthesiologists (ASA)
Michael W. Champeau, M.D., FASA stated the following in a press release
concerning the 2023 CF:
The CMS final rule underscores how the Medicare
payment system is broken, especially during a time when anesthesia groups are
faced with inflation pressures, the COVID-19 pandemic, and health care worker
burnout. ASA has urged and will continue to advocate to Congress and regulatory
agencies to minimize and reverse these cuts that negatively impact
anesthesiologists and the care they provide to the important Medicare patient
Furthermore, these changes may affect the retention and
recruitment of an already challenging market to include inflation and the impact
of COVID-19. Although this ruling has been published there is momentum being
made to reverse these reductions as have been done in the past.
Facilities with a substantial government payer mix find that
their O.R. contribution margins are being negatively impacted due to the rapidly
escalating salaries. In addition, the traditional, subsidy-based anesthesia
relationship does not provide the flexibility and value-added services required
to navigate the upcoming market conditions.
Due to the reduction in rates, facilities acknowledge that a
new solution is required to respond better to the challenges in the anesthesia
market. The solution combines greater use of data, value-added perioperative
consulting, collaboration with your surgical services leadership, and alignment
of anesthesia leadership with your goals.