UnitedHealthcare anesthesia cuts spark backlash over patient access risks

Editor's Note

UnitedHealthcare’s 15% cut to certified registered nurse anesthetist (CRNA) reimbursements has ignited strong opposition from anesthesia leaders who warn the policy could endanger patient access to safe, affordable care in rural and underserved areas, Nurse.org October 14 reports.

On October 1, UnitedHealthcare implemented the new policy, reducing payments for anesthesia services performed independently by CRNAs and billed under the QZ modifier. The reduction applies nationwide except in eight states—Arkansas, California, Colorado, Hawaii, Massachusetts, New Hampshire, Ohio, and Wyoming.

As detailed in the article, the American Association of Nurse Anesthesiology (AANA) condemned the change as discriminatory and potentially unlawful, saying it targets CRNAs based solely on their licensure despite identical clinical responsibilities to physician anesthesiologists. AANA President Jan Setnor argued the move will disproportionately harm communities where CRNAs deliver more than 80% of anesthesia services, leading to delays in critical procedures such as cancer screenings and gastrointestinal diagnostics.

The outlet reports AANA and nine allied organizations have asked the US Secretaries of Health and Human Services, Labor, and Treasury to investigate and block the policy, citing possible violations of the Affordable Care Act’s provider nondiscrimination clause. Coalition members contend the insurer should instead support equitable reimbursement that sustains anesthesia coverage in high-need regions.

UnitedHealthcare has defended the decision as aligning reimbursement with provider licensure and scope of practice while helping to manage healthcare costs. Critics counter the change amounts to cost-shifting that threatens care access, workforce stability, and the financial viability of CRNA-led services. As advocacy groups mobilize, nurse anesthetists and healthcare organizations nationwide are pressing for policy reversal, emphasizing that fair compensation for CRNAs is essential to preserving anesthesia access across the continuum of care.