Ep 156: How the Economics of Healthcare Could Change Anesthesia

Money drives many of the decisions industries have to make and healthcare is no exception. As things become more expensive and less efficient, people are looking for ways to improve the quality and cost of care. Ian Hewer, PhD, CRNA, is an assistant professor at Western Carolina University and has turned much of his focus to healthcare economics and QZ team billing. Today he’ll tell us more about this team approach, how it’s impacting cost, and why it’s a good thing for CRNAs.    

Click the timestamps below to help you navigate through the many topics we discussed.

On This Episode:

The cost of healthcare has been a significant concern for many Americans for some time, but it seems to be more relevant today than ever. Prices continue to rise while care remains inefficient, and more and more people are trying to find ways to change this trend.

We’re seeing some of that in anesthesia, where a team concept is being utilized more and more. This is something that Ian Hewer, PhD, CRNA, has been following closely. He’s practiced for a long time in Asheville and his interest was piqued when he learned about a new billing model that allowed a practice to operate with fewer anesthesiologists.

We’ve invited him on the show to learn more about the economics of healthcare and what the future could hold for CRNAs. We’ll let him give you all the details, but the good news is this shift appears to be a positive for those working in anesthesia.

As you get started on the episode, keep an ear out for these topics:

  • How he became interested in this topic
  • The rise of the team concept in anesthesiology
  • Why the QZ model has led to consolidation of employers
  • How will this impact the future of anesthesia
  • What the average anesthetist makes in a socialist system
  • Looking at outcomes vs amount spent
  • Why he thinks we’ll see more CRNA-driven care in smaller settings

Check it out the interview at the top of the page and use the timestamps to help you navigate through the many topics we discussed.

4:34 – Introducing today’s guest and topic

6:53 – The anesthesia care team model

11:24 – Background on QZ billing

14:15 – Supervision

16:45 – How will affect the future of anesthesia?

22:48 – What does the average anesthetist make?

26:03 – Outcomes vs amount spent

30:57 – Solutions for the future

35:49 – What patients think of their care

37:02 – Problems with employer-based insurance system

38:34 – Two options we face

42:46 – CRNAs in good position

44:10 – Lightning Round

“Whoever the deals the care safely, efficiently, and cheaply is going to be the winner.”

– Ian Hewer, PhD, CRNA






Ep 226: The Need for More State Nurse Legislators

We talk all the time about the lack of nurse representation in policy-making positions, but that doesn’t make the data any less surprising. Today we’ll have a great discussion with Darlene Curley, EdD, RN, FAAN, about a study she recently completed on state nurse legislators. She’ll share some of the details with us in this episode and we’ll also have a wide-ranging discussion on how CRNAs and other nurses can continue increasing their involvement.  

Current Events

Ep 225: An Inside Look at Lobbying for Your State Association

During our visit to the NCANA meeting last fall, we had the opportunity to host a live podcast about lobbying for your state association and we had the pleasure of bringing NCANA lobbyists Patrick Ballantine and Tracy Kimbrell onto the panel with us. Both of them have been tremendous assets to our association because of their passion for lobbying. We explored that role to find out what skills it takes, how to utilize a lobbyist, and what you should expect from them.


Ep 224: ASA 2022 Difficult Airway Algorithm Update

The American Society of Anesthetists initially released the Difficult Airway Algorithm in 1993 to provide a guide for managing a patient with a difficult airway. It has been updated every 10 years since with the fourth iteration being released in January 2022.
The latest update has a number of key changes that Jeremy and Sass will take you through in this episode of the podcast.




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J. Cross CRNA
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This podcast is very well put together. I love the hosts Sharon & Jeremy, they do a fantastic job at presenting topics as well as getting great speakers on the show! This is my morning commute podcast everyday! Thank you for all that you do!
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I enjoy listening every morning. Great content and always a pleasure to learn something new.
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I started listening to this podcast religiously early on in my CRNA journey, a year before applying to CRNA school. The content in this podcast was one of my most helpful resources for getting into my first choice school, Wake Forest! It has also been a huge motivator for getting involved with the AANA now and throughout my career. I highly recommend this podcast to every prospective CRNA I meet.
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I appreciate hearing the latest and greatest in the world of Nurse Anesthesiology while also getting Class B credits. Just listen on your commute for a win/win experience. I love the perspectives from Jeremy and Sharon who both ask varied and insightful questions!
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If you’re a CRNA or any medical professional, I highly recommend giving this podcast a listen. Hosts have a great rapport.