Anesthesia stipends — once rare in the ASC industry — have become a common practice for many ASCs as labor costs climb, federal reimbursement lags and the gap between what anesthesia services cost and what payers reimburse ever widens.
The share of ASCs expecting to pay anesthesia stipends jumped from 28% in 2024 to 44% in 2025, according to a VMG Health report published in October 2025.
Some leaders warn that the growing reliance on stipends reflects deeper structural inefficiencies in the traditional ASC model — and the practice is likely here to stay.
Thomas Durick, MD, an associate professor of anesthesiology at The Ohio State University Wexner Medical Center in Columbus, recently joined Becker’s to discuss why anesthesia stipends have become a mainstay in the ASC space and what it might take to reverse the trend.
Editor’s note: This response has been lightly edited for clarity and length.
Question: We’ve discussed how anesthesia stipends have become part of the payment structure on the surgery center level. Do you see that trend sticking around for a while?
Dr. Thomas Durick: Unfortunately, I do. When you look at reimbursements versus cost, those two trends are going in opposite directions. Our reimbursements are dropping, our costs are going up, and the margins are shrinking. Will we hit a critical point where some surgery centers go, “We just can’t afford to pay this anymore. We just can’t.” That’s where some of these private equity companies jump in and say, “We can do it for less.” They don’t always look at job satisfaction or the quality metrics of those surgery centers. You read about this in Becker’s all the time: A hospital system fires its anesthesia group, bringing in private equity. They hope that the anesthesia team will stay on, but they’re going to take a 20% pay cut to work 20% more. That also is not sustainable, but unfortunately, it’s becoming the norm. Private equity comes in. They take their profit one year, and then things go south. Now you’re looking at renegotiating again. So I unfortunately don’t see that trend changing. I would love to see anesthesiologists and nurse anesthetists, and both their parent organizations, unite to use their combined strengths to battle this trend of decreasing reimbursements from the government, private equity and insurance companies—rather than fighting each other over turf wars. There are plenty of jobs out there. We just have to stop stabbing each other to try and fend off the insurance companies, which are the ones that are really strangling us.
