Download this proposal as a PDF.

Commenting for this proposal will be open until the close of business on Monday, June 5.

Title of Proposal:

Licensure of Certified Anesthesiology Assistants

On behalf of:       

Virginia Society of Anesthesiologists

Describe the Idea or Issue:

The Virginia Society of Anesthesiologists (VSA) requests that the Medical

Society of Virginia advocate for a bill permitting the licensure of certified anesthesiologist assistants (CAAs) in the Commonwealth during the 2018 General Assembly Session.

Desired Outcome:

The VSA requests that the Medical Society of Virginia advocate for a bill permitting the licensure of CAAs in the Commonwealth during the 2018 General Assembly Session. This is an issue that should be important to the House of Medicine, not just to anesthesiologists, because it impacts:

  • Provider shortages
  • Access to care
  • Economic efficiencies and optimization
  • Selection of mid-level practitioner to best suit patient needs

Licensure of CAAs would help alleviate all of these issues, so we are seeking the support of the entire community of medicine in this endeavor.

Background/Supporting Information:

CAAs are highly skilled health professionals who work under the direction of licensed physician anesthesiologists to implement anesthesia care plans. All CAAs possess a premedical background, a baccalaureate degree and complete a comprehensive didactic and clinical program at the master’s level.

CAAs work exclusively within the anesthesia care team environment and, unlike nurse anesthetists; they must be supervised by a physician anesthesiologist.

Eighteen jurisdictions as well as the District of Columbia currently regulate CCAs. Virginia is surrounded by other states that have already adopted the CAA approach (North Carolina, Washington, D.C., Kentucky and Ohio).

There are 10 accredited CAA educational programs in the U.S. There are nearly 2,000 CAAs already practicing throughout the nation.

Eighteen jurisdictions as well as the District of Columbia currently regulate CCAs. Virginia is surrounded by other states that have already adopted the CAA approach (North Carolina, Washington, D.C., Kentucky and Ohio).

CAA students currently rotate through Virginia hospitals, but must go elsewhere to work when they finish training. There are currently about a dozen CAAs who reside in Virginia but travel to work elsewhere (including Arlington, Alexandria, Danville, Fort Royal and Williamsburg).

Anesthesiologists are the only physicians in the Commonwealth with only one physician-extender option (nurse anesthetists). CAAs would provide an additional choice of physician-extenders for anesthesiologists who adhere to the Anesthesia Care Team model of patient care.

CAAs are recognized by CMS, Tricare and all major commercial payers. Data from the Bureau of Labor and Statics shows that the cost of nurse anesthetists decreases in the states with the highest number of CAAs:

Mean Wage

Nationwide Rank in CAA Employment

  • Georgia - $137,940 - 1
  • Florida - $143,870 - 2
  • Ohio - $152,310 - 3
  • Texas - $161,740 - 4
  • Missouri - $151,330 - 5
  • Virginia - $171,160 - None

*Note – Texas is likely still above average because the 130 CAAs don’t compete significantly with the 32,000 nurse anesthetists statewide.

The VSA has been studying CAAs for several years, and has watched with interest as other states have adopted CAA licensure. The VSA surveyed its members in August of 2015, and found that:

  • 88% of its members thought that having CAAs as an available physician extender alternative to nurse anesthetists would be a good for anesthesiologists in Virginia.
  • 74% of members said that their current practice would use at least one CAA as an alternate physician extender.
  • 42% of members said that their current practice would use more than five CAAs as an alternate physician extender.

The Virginia Department of Health Professions is currently evaluating the feasibility of state licensure for CAAs. The Virginia Society of Anesthesiologists plans to pursue legislation licensing CAAs during the 2018 Genera Assembly Session.

Additional background materials in appendix.

Add comment

2017 Advocacy Summit Proposals
Give to MSVPAC