UnitedHealthcare has recently implemented a new reimbursement policy that cuts payments for anesthesia services delivered by Certified Registered Nurse Anesthetists (CRNAs) to 85% of the physician fee schedule. This is not a routine adjustment. It’s a targeted policy that undervalues the essential care CRNAs provide and threatens access to safe anesthesia services across Minnesota.
This decision increases corporate profits at the expense of patients, hospitals and the health care professionals who deliver anesthesia care every day. It does nothing to improve outcomes or address inefficiencies. Instead, it places new financial burdens on health care facilities and risks destabilizing hospitals and clinics already struggling with workforce shortages and budget pressures.
In Minnesota, the consequences are real. CRNAs are the backbone of anesthesia care in our state. Approximately 2,000 CRNAs are authorized to deliver anesthesia services to Minnesota patients, ensuring safe, high-quality care in every setting, from large surgical centers to small community hospitals. In most rural communities, CRNAs are the sole anesthesia providers, and their presence often determines whether a hospital can continue offering surgical, obstetrical and trauma care.
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When UnitedHealthcare reduces reimbursement only for CRNAs, hospitals are forced to absorb the cuts or increase stipends and subsidies. That diverts scarce resources away from patient care and community health. For critical-access hospitals that operate on thin margins, these changes can mean delaying procedures, reducing services or even closing operating rooms. Patients in Greater Minnesota deserve better than to see their access to care jeopardized by a corporate policy made hundreds of miles away.
We believe this policy violates both federal and Minnesota law designed to protect patient access to qualified health care professionals. Under the Affordable Care Act’s provider nondiscrimination provision, health insurers are prohibited from discriminating against licensed health care professionals who provide services within their scope of practice.
This federal law specifically bars discrimination in reimbursement based solely on a provider’s license type. Minnesota law also requires insurers to cover services performed by CRNAs, when those same services would be covered if performed by physicians. Paying physicians 100% for anesthesia services while reimbursing CRNAs at only 85% for identical services appears to violate both laws. This discriminatory reimbursement creates a financial disincentive that will ultimately limit patient access to qualified anesthesia professionals and undermine the very purpose these laws were designed to serve.
As an assistant professor in anesthesiology and a CRNA with over 20 years of experience, I see firsthand the skill, training and dedication CRNAs bring to their patients. We complete years of advanced education and clinical preparation, culminating in a doctoral degree. We manage anesthesia for patients of all ages and across every type of surgical and procedural setting. Our care is safe, efficient and cost-effective — and has been for decades. To suddenly devalue that care sends the wrong message to health care professionals, patients and hospital systems alike.
This policy is not just a financial issue; it’s a patient access issue. Its ripple effects reach beyond operating rooms to maternity care, emergency response and outpatient procedures. If rural hospitals are forced to cut services, patients can expect longer wait times, more travel for care and greater risks from delayed treatment. When insurers decide whose work is “worth” less, the people who pay the price are patients.
Notably, all of Minnesota’s health insurers, except one, have maintained equal reimbursement for CRNAs and physicians providing the same anesthesia services. This longstanding practice demonstrates that insurers can comply with federal and state nondiscrimination laws while remaining financially sustainable. UnitedHealthcare stands alone in Minnesota in implementing this discriminatory policy.
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We’ve seen other insurers reverse similar policies after recognizing the harm they caused. UnitedHealthcare should do the same here in Minnesota. There is no justification for a policy that undermines patient access, weakens hospitals and devalues highly trained professionals who have been trusted anesthesia providers for generations.
Minnesota’s patients and hospitals should not be forced to subsidize UnitedHealthcare’s corporate profits. We call on UnitedHealthcare to reconsider and rescind this harmful policy, and we urge Minnesota regulators to fulfill their responsibility to enforce federal provider nondiscrimination protections and ensure health care access remains fair and equitable for every community across our state.
Our hospitals, our patients and our communities deserve better.
Robyn Finney, APRN, CRNA, DNAP, FAANA, is president of the Minnesota Association of Nurse Anesthetists.
The post Minnesota hospitals, patients will be hurt by UnitedHealthcare policy appeared first on MinnPost.
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