With anesthesia shortages dragging on and outpatient cases getting more complex, SCA Health, Optum’s ASC division, is thinking long-term in regards to how anesthesia is staffed and delivered.
Leaders told Becker’s the answer isn’t a short-term patch. Instead, SCA is leaning into top-of-license practice, closer clinical alignment with anesthesia teams and tighter operational management driven by data.
Stephanie Perna, regional vice president of operations for Kentucky, said SCA expects the shift toward top-of-license work to continue across anesthesia roles.
At Owensboro Surgery Center, that approach is already taking shape. The ASC’s CEO Marti Gaw told Becker’s the center moved from an anesthesiologist-supervised model to a CRNA-only structure. The transition was planned in advance to avoid disrupting care and to strengthen safety support for emergencies.
“Our ability to make this shift was rooted in the experience and professionalism of our CRNA staff,” she said. “We enhanced emergency response protocols and ensured the availability of additional support staff when rapid response is needed. CRNAs are empowered to operate at the top of their license and are deeply involved in ongoing clinical education and preparedness initiatives.”
SCA leaders also are preparing for rising outpatient volume and higher-acuity cases. To take on that growth safely, Ms. Perna said centers are tightening how they evaluate patients who may be on the edge of ASC eligibility.
“We have incorporated in-person assessments for patients with borderline ASA risk to ensure safe access to ASC care,” she said. “Our approach is grounded in high-touch, high-quality care that balances efficiency with thorough clinical assessment.”
Workforce changes are being paired with closer operational oversight. Lindsey Lowder, group vice president of operational strategy and innovation, told Becker’s that SCA uses Tableau dashboards to monitor anesthesia-linked performance measures such as first-case on-time starts, PACU length of stay, OR utilization, anesthesia medication use and cancellations, broken down by cause, physician and service line.
“These dashboards empower our operators and clinical leaders to dive deep into performance data, identify trends and uncover opportunities for process improvements,” she said. “This data-driven approach helps us proactively address scheduling inefficiencies and reduce the risk of same-day cancellations.”
SCA is also trying to cut avoidable day-of-surgery issues by improving pre-op communication. ASCs send personalized texts and emails ahead of procedures to clarify instructions and reduce last-minute confusion.
Looking ahead, SCA Health is expanding direct employment for anesthesia providers as another way to stabilize staffing.
“This strategic shift strengthens coordination, accountability and alignment with center operations, ultimately leading to smoother workflows and better patient experiences,” Ms. Lowder said. “We’ve also developed internal tools to monitor how effectively anesthesia providers are being utilized during their scheduled time, allowing us to optimize staffing and resource allocation across our facilities.”
Leaders said the goal is to build anesthesia models that are financially sustainable without sacrificing day-to-day clinical performance.
“One of the clearest lessons is that what’s good for minimizing anesthesia costs is often just good for healthy center operations overall,” Ms. Perna said. “The most effective models are those where we have tight alignment with anesthesia providers — whether through direct employment or strong, ongoing communication with third-party groups. This alignment fosters shared accountability, smoother workflows and better outcomes. This also helps ensure that our patients are receiving quality-driven, affordable care.”
