The Issues

Missouri Healthcare Rankings among Lowest in Nation

Missouri is in crisis–currently rated 47th for overall healthcare performance. We are down to 35 critical access hospitals to serve 2.06 million rural Missourians and we cannot afford to lose any more hospitals. Yet Missouri laws remain outdated and do not support rural hospitals or healthcare providers.

Missouri is also ranked 48th for highest number of healthcare provider shortages. Current state regulations are more restrictive than federal regulations and not allowing full scope of practice for advanced practice nurses is making APRNs and CRNAs leave the state. No other state that surrounds Missouri has CRNA supervision in their state Nurse Practice Acts. And we are losing CRNAs to other states because they are seeking jobs without restrictions on their practice authority. 

Restricting CRNA Practice Reduces Access to Care and Increases Costs

Restricting CRNA practice is contrary to the national trend toward allowing APRNs to practice to the full extent of their education and training.

Allowing CRNAs to practice to the full extent of their training and education improves access to high quality, cost-effective care, and decreases healthcare costs. Unnecessary restrictions on CRNA practice are not cost-effective and actually increase healthcare costs. Further, imposing such restrictions on CRNA practice is not supported by published research.

Essential Access to Anesthesia Care

Research shows that CRNAs are the most cost-effective anesthesia providers and that there is no difference in safety between CRNAs and physician anesthesiologists. CRNAs provide essential access to anesthesia care, especially in rural and other medically underserved areas in our state and the rest of the United States.

In Missouri, CRNAs work in all hospitals with surgical services, and are the only anesthesia provider in 78% of rural Missouri Hospitals. Without CRNAs these facilities would not be able to provide surgical services.

THE SOLUTION

• SUPPORT RURAL HOSPITALS:
  Relieve burdens and allow hospitals to choose their own anesthesia model and supervision requirements.
• SUPPORT RURAL HEALTHCARE PROVIDERS:
  Remove restrictions on CRNAs and the supervision requirement from operating providers.
• SUPPORT ADVANCED PRACTICE NURSES:
  Permit CRNAs to work to the full scope of their training and education.
• UPDATE OUTDATED LAWS:
  Align Missouri with 43 other states who do not require supervision of CRNAs.
• IMPROVE MISSOURI HEALTHCARE:
  Redirect the focus back to the patients, not protocols or regulatory interpretations.