Today’s anesthesia leaders are navigating unprecedented financial pressure and structural change. With declining reimbursements, rising costs and shifting care models, anesthesia groups must maintain patient safety and operational efficiency while working with tighter margins than ever before.
Here are five ways anesthesia practices are adapting to the reimbursement squeeze:
1. Contract restructuring and financial alignment: Reimbursement for anesthesia services has steadily declined in recent years. The average anesthesia reimbursement rate in 2023 was $21.88 per unit, a 5.5% decrease from 2019.
For Medicare specifically, reimbursements fell from $22.27 per unit in 2019 to $21.12 in 2023.
These declines come as costs for staffing, supplies and compliance continue to rise.
Anesthesia groups and facility partners are renegotiating coverage contracts, exploring joint-venture and risk-share models and securing stipends or subsidies from ASCs to shore up viability in a lean reimbursement environment.
2. Workforce innovation and retention strategies: The anesthesia workforce shortage is deepening just as reimbursement pressures intensify. Nearly 30% of anesthesiologists are projected to leave the workforce by 2033 — creating a potential shortfall of 12,500 providers.
More than 56% of active anesthesiologists are age 55 or older, and 17% are nearing retirement.
To adapt, anesthesia groups are emphasizing retention and recruitment strategies — including wellness initiatives, mentorship programs and flexible scheduling to reduce burnout and retain senior clinicians. Many are also increasing reliance on CRNAs and anesthesiologist assistants as part of tiered staffing models to maintain coverage amid shortages.
3. Expanding into outpatient and nonoperating room anesthesia: As more procedures shift from hospitals to ASCs and nonoperating-room anesthesia settings, anesthesia teams are adapting their operational and care-delivery models.
ASCs expanding into higher-acuity specialties such as orthopedics, spine and cardiology are placing new demands on anesthesia teams.
To keep pace, anesthesia groups are developing multi-site staffing systems that allow anesthesiologists to cover several outpatient facilities efficiently and adopting virtual preoperative assessments to streamline care. They are also cross-training staff and coordinating coverage through centralized operations, helping maintain service sustainability despite lower per-case reimbursement.
4. Building strategic partnerships with ASCs and hospitals: Anesthesia groups are increasingly moving away from transactional contracts toward strategic partnerships that tie performance to outcomes and efficiency.
Groups are collaborating on throughput optimization, sharing data transparency and even co-owning facilities to stabilize income and share risk.
5. Leveraging technology for efficiency and value: Technology is emerging as a key adaptation tool in the face of declining reimbursement. Anesthesia practices are adopting AI-assisted scheduling, digital preoperative assessments and predictive analytics to improve efficiency and reduce idle time.
These tools help cut administrative burden and enhance data accuracy. Some anesthesia practices are also using analytics to demonstrate value in negotiations with payers and facilities, connecting cost savings and clinical performance to contract renewals.
