The operations, staffing and finances behind anesthesia services have become one of the most challenging aspects of ASC management and growth in recent years.
As a result, ASC leaders have been forced to look closely at how they organize and manage their anesthesia services. Three ASC leaders joined Becker’s to discuss the changes they’re making in anesthesia and how it has benefitted their centers.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What’s one change you’ve made to your anesthesia operations in the last year? How did it improve efficiency at your facility?
Suzi Cunningham. Administrator of Advanced Ambulatory Surgery Center (Redlands, Calif.): Our center has changed from an all-MD anesthesia model to an MD/[certified-registered nurse anesthetist] anesthesia model, after 20 years of business, due to the need for our center to supplement reimbursement to the anesthesia providers. Further, we no longer provide general anesthesia to our surgeons on Fridays and only do local cases on these days. And, even with these changes, we are spending more than ever before on anesthesia. This is not a sustainable business model, in my opinion, but for now, it seems we have no choice.
Tracy Helmer, BSN. Administrator of Tri City Cardiology Surgical Center (Mesa, Ariz.): The most impactful improvement came from meaningful collaboration with our anesthesia group to sit down and discuss how we can trust their guidance on efficiency strategies. We took actionable steps on suggestions like adjusting block times, starts, asking for slightly more productive case mixes (such as sprinkling in some commercial cases, when possible),and even looking at ways that our providers could help with providing anesthesia to patients that we had traditionally excluded them from. We found that our particular group was very knowledgeable about ways to be efficient, not so much about how to get more units. It was about how to maximize the workload that was already occurring, so that we provided better care, and they received a more balanced compensation for time spent. We didn’t realize, until they helped us see, just how much unproductive time can occupy an anesthesia provider’s time, so we have to respect their time and work with them to show them that we really do appreciate them being here in our centers. It helps everyone and at the end of the day, care is shifting toward the ASC, so we want to make the ASC environment conducive for our anesthesia friends to come work. Getting them involved and trusting their advice is a great way to do so.
Joe Martin. CEO of Valley Regional Anesthesia Associates (Fresno, Calif.): One of the most impactful changes we made in the last year was strengthening our anesthesia operations through a centralized scheduling and staffing model supported by real-time data dashboards. Historically, coverage was managed site-by-site, which often led to inefficiencies, overtime and variability in case starts. By consolidating scheduling across all of our facilities, we created a single pool of providers that we can deploy flexibly based on case volume and acuity.
This shift improved first-case on-time starts, reduced idle time, and cut down on unnecessary locum usage. It also allowed us to match provider skillsets more effectively with case complexity, improving both patient safety and surgeon satisfaction. Operationally, it increased EBITDA margins by reducing wasted staffing dollars, while also improving provider satisfaction by creating more predictable assignments and better work–life balance.
