Anesthesia coverage has become one of the costliest and least predictable pieces of running an ASC. Groups are responding by pitching tighter staffing models, while some centers are walking away from physician-led groups altogether.
Here are four recent anesthesia developments to know:
1. Hackensack, N.J.-based Olena Medical is promoting its physician-led anesthesia model as a staffing and coverage partner for ASCs, according to an Oct. 23 news release. The company said it works with ASC leaders to match anesthesia coverage to each facility’s clinical needs, scheduling demands and goals, and names staffing problems, scheduling disruptions and uneven coverage as threats to operating room efficiency.
“We are building a model that supports clinicians, improves facility performance,” said Mrinal Agrawal, MD, chief medical officer of Olena Medical.
2. NorthStar Anesthesia has added 17 ASC partnerships nationwide so far in 2026, the Irving, Texas-based anesthesia provider said Oct. 23. New partners include CarePlex Orthopaedic Ambulatory Surgery Center in Norfolk, Va.; MedRVA Healthcare’s Stony Point Surgery Center and West Creek Surgery Center in Richmond, Va.; Eye Surgery Center of Homewood (Ala.); and The Toledo (Ohio) Clinic ASC. NorthStar CEO Adam Spiegel told Becker’s that about 80% of ASCs in the company’s network now require anesthesia stipends, up from 10% to 15% before the pandemic.
“The challenge for ASCs today isn’t simply finding anesthesia coverage. It’s ensuring that coverage translates into reliable surgical capacity,” said Cindy Myers, vice president of ASC operations at NorthStar.
3. In some states, ASCs are ending contracts with physician anesthesia groups and hiring groups made up only of certified registered nurse anesthetists to control costs. California is one of 27 states that have opted out of the federal Medicare requirement for physician supervision of CRNAs. Proliance Surgeons’ ENT ASCs near Seattle moved to a CRNA group in late 2024 after their physician anesthesia group could not staff the centers consistently. Some anesthesia leaders say higher-acuity cases moving into ASCs make the switch riskier.
“Centers need to make sure that whoever they’re partnering with, anesthesia group-wise, they can cover these high-acuity cases,” said Megan Friedman, DO, chair and medical director of Los Angeles-based Pacific Coast Anesthesia.
4. Mobile, Ala.-based USA Health is planning an anesthesia residency program and named Gregory Bouska, MD, interim chair of the new Department of Anesthesiology at the Frederick P. Whiddon College of Medicine, according to an Oct. 21 university news release. Dr. Bouska has been chief of anesthesia services at the health system since November 2022.
“This provides the necessary home for a new residency training program in anesthesia,” Jeffrey La Rochelle, MD, dean of the Whiddon College of Medicine, said in the release.
5. Nearly one-third of ASCs offer financial assistance in their contracts with anesthesia providers or groups, according to the Ambulatory Surgery Center Association’s third-quarter 2026 60-Second Survey of 307 respondents. Here are four more numbers from the survey:
- 31% of ASCs offer financial incentives in anesthesia contracts, up from 30% in 2024.
- 43% of large ASCs offer financial assistance, the highest of any group.
- 51% of centers that offer assistance cite stipend contracts as the most common form, and 29% cite collections guarantees.
- 15% use flat subsidies in 2026, down from 21% in 2024 and 27% in 2023.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
