<p>Most anesthesiologists work in groups and most CRNA's are employed by anesthesia groups. Few anesthesiologists are directly employed by the hospital, but many groups receive subsidies from the hospital.</p>
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[quote]
There are many groups that receive subsidies and stipends from hospitals to provide services. These subsidies can include, but are not necessarily limited to: compensation for call coverage, stipends for medical director activities, compensation for differences between the cost of locum tenens and the groups own providers, or subsidies due to poor payer mix.
[/quote]
<a href="http://www.asahq.org/Newsletters/2004/09_04/pracMgmt09_04.html%5B/url%5D">http://www.asahq.org/Newsletters/2004/09_04/pracMgmt09_04.html</a></p>
<p>Using CRNA's could affect the total cost of anesthesia for a hospital in at least two scenarios: First, if the hospital is paying a contracted amount to a group for anesthesia services, using salaried CRNA's under anesthesiologist supervision in a large OR suite could reduce the bid amount. Second, in those states where physician supervision of CRNA's is not required, hospital employment of CRNA's could reduce cost to the hospital as long as the surgeons were willing to accept the increased liability due to the captain of the ship doctrine. (For a list of the states see: <a href="http://www.aana.com/Advocacy.aspx?ucNavMenu_TSMenuTargetID=49&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=1790%5B/url%5D">http://www.aana.com/Advocacy.aspx?ucNavMenu_TSMenuTargetID=49&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=1790</a>)</p>
<p>Where anesthesia work is strictly fee for service, presence or absence of CRNA's should not affect the cost of anesthesia to the hospital.</p>