Anesthesia access across the rural U.S. is declining, risking delayed care, canceled procedures and widening health disparities.
This disparity in care persists across staffing models and practice settings, fueled by a wave of anesthesia providers exiting the industry as well as a bottleneck of new anesthesia residents entering the field.
By 2026, the U.S. is projected to face a shortage of 6,300 anesthesiologists, according to a report from Medicus Healthcare Solutions. Currently, there are more than 7,700 patients per anesthesiologist. More than 56% of anesthesiologists are older than 55, and more than 17% are nearing retirement.
Here are five things to know about anesthesia’s rural care gap issue:
1. CRNAs deliver more than 80% of anesthesia services in rural counties, administering over 50 million anesthetics each year, according to the American Association of Nurse Anesthesiology. Yet staffing gaps are ballooning, with facilities reporting anesthesia shortages rose from 35% in 2020 to 78% by late 2022, and nearly 22% of anesthesia providers being projected to leave the workforce by 2033.
2. The anticipated shortage is compounded by a tightening pipeline. As of 2025, new CRNA graduates must earn doctoral degrees — and CRNA schools average just a 24% acceptance rate.
3. Meanwhile, financial headwinds such as insurer caps on CRNA reimbursement at 85% of physician rates are undermining rural practice viability. UnitedHealthcare issued a policy update July 1 that cuts reimbursements for CRNAs by 15% effective Oct. 1. “This cut singles out CRNAs despite using the same techniques as other anesthesia providers,” American Association of Nurse Anesthesiology President Jan Setnor, MSN, CRNA, told Becker’s. “It’s unacceptable, especially amid a national shortage of anesthesia providers.”
4. Industry experts have recommended urgent interventions such as expanding state-level CRNA full practice authority, increasing anesthesia training capacity, offering rural loan repayment incentives and using real-time geospatial tools to target shortage zones.
5. A shortage of physician anesthesiologists is adding to the strain. By 2036, the U.S. is projected to be short 6,300 anesthesiologists. The gap is fueled by retirements, burnout and limited training capacity: Eight states have no anesthesia residency programs, and about 44% of medical students seeking anesthesiology residencies did not match in 2024.
