Anesthesia shortages continue to squeeze ASCs, pushing many to search for new ways to maintain procedural access. SedAssure, a new sedation management company led by CEO Marc Koch, MD, aims to close those gaps with a model built around safety, compliance and reliability.
Dr. Koch said the idea for SedAssure took shape after years of watching facilities struggle to keep procedures on schedule as coverage became increasingly unpredictable.
“The biggest takeaway was that people are concerned,” he told Becker’s. “They’re worried about what they don’t know — and about what they’re seeing. Cases are getting delayed, canceled, rescheduled. People are thirsty for new ideas, innovative approaches to old problems, and solutions that are safe and make patients comfortable for their procedures.”
He said SedAssure’s decision to move forward was grounded in data showing the shortage is not temporary. Workforce projections indicated the problem could persist for much of the next decade, leading to the question of how centers could sustain operations without compromising safety.
“The more we looked at the workforce projections, the more we saw things were not going to get better anytime soon,” Dr. Koch said. “It probably wasn’t going to stabilize until around 2030 and it wasn’t going to turn around until 2032. … There was no cavalry coming.”
With that reality in mind, SedAssure was built as a comprehensive framework — one that combines technology, education and clinical governance to professionalize sedation delivery.
“Given the technological advances, pharmaceutical advances and what we know from the evidence, we asked, ‘Can we step it up a notch?’” he said. “Can we professionalize the delivery of sedation and make it safe, standardized and reliable?”
Central to that vision is clinician education. Dr. Koch said sedation training has too often been limited to short courses rather than rigorous preparation.
“If you take a look at how sedation heretofore was accomplished, you might have a weekend course with coffee and PowerPoints,” he said. “Our view is that this needs to change. There needs to be a broad, deep treatment of what sedation is — patient triage, procedure triage, care protocols, decision support — all of it.”
He added that compliance and accreditation must be built into that model from the start. SedAssure’s framework aligns with Medicare’s participation and coverage requirements, as well as national accreditation standards.
“It’s much more than having a clinician,” Dr. Koch said. “It’s the structure around them that makes the service timely, safe and complete.”
Over time, he believes sedation will emerge as its own recognized specialty, much like hospital medicine or interventional radiology did decades ago.
“Thirty or forty years ago, there was no hospitalist — it was just doctors covering the hospital,” he said. “Eventually that became an area of practice. I think you’re going to see the same thing with sedation.”
He envisions the development of university-based certificate programs supported by comprehensive coursework and practical experience.
“Maybe it’s a certificate supported by a broad, deep educational experience,” he said. “At some point, that credential will be recognized by malpractice carriers, liability carriers, payers. That’s where I think this is going.”
Since SedAssure’s launch, interest from ASC leaders has been immediate. Many, Dr. Koch said, recognize the urgent need for a reliable and compliant solution.He sees technology playing a growing role in the safety and consistency of sedation delivery. Predictive analytics, AI-driven monitoring and decision-support tools, he said, are already reshaping what’s possible.
“You’re starting to see predictive analytics that can look at data in real time and say, ‘This person needs more oxygen now because if I don’t give it, they’ll desaturate in three minutes,’” Dr. Koch said. “I don’t think we’ll see a machine replace a sedationist in my lifetime, but I do think you’ll have a co-pilot — tools that make patients safer and clinicians more confident.”
For Dr. Koch, patient safety is the core metric guiding every decision.
“Whatever we do has to always put patients first, second and third,” he said. “If what we’re doing is safe based on the evidence and leads to comfortable patients for their procedures, that’s a win.”
He believes surgery centers that adapt now — rather than waiting for workforce relief that may not come — will be the ones best positioned to thrive.
“Hope is not a strategy,” Dr. Koch said. “Saying something will be doesn’t make it so. The smart office-based facilities and surgery centers will recognize where we are, where we’re going and begin thinking about new solutions — particularly on the sedation front — because it’s a pathway forward. It’s a way to deal with the issue.”
