Beginning November 1, 2017, the reimbursement rate to an anesthesiologist supervising a CRNA or AA will decrease from 75 to 50 percent and the reimbursement to a CRNA or AA supervised by an anesthesiologist will decrease from 92 to 50 percent of the calculated rate. Medical services solely performed by an anesthesiologist will receive 100 percent while a CRNA who is supervised by a physician will receive 92 percent of the calculated rate. The testimony indicated support for the rate changes as well as an anesthesia team approach. The problems identified through testimony are largely found in the complex cases served at trauma facilities and children’s hospitals. Here the service cost will exceed the rate and could cause an access to care problem.