As private equity-backed anesthesia companies expand and large groups secure more hospital and ASC contracts, independent practices face growing pressure. Many are pushing back with strategies designed to protect autonomy, strengthen negotiating power and preserve their role in the market.
Here are five ways independents are resisting consolidation:
- Forming alliances and independent practice associations: One of the most direct responses to consolidation has been the creation of independent practice associations. where independent anesthesia groups and ASCs band together.
By pooling resources and presenting a united front, independents gain greater bargaining power with insurers and health systems. This collaborative model also helps share administrative costs and mitigate the vulnerability of being a standalone provider.
- Emphasizing local flexibility and responsiveness: Independent anesthesia groups are leaning into their ability to quickly adapt staffing and operations to local needs, something larger national organizations often struggle to match. This means tailoring schedules, aligning anesthesia coverage with specific surgical specialties and maintaining closer relationships with surgeons and administrators.
This flexibility and local control can be the most effective means independents use to differentiate themselves from corporate groups that may impose standardized staffing models.
3. Highlighting physician-led governance and autonomy: Independent anesthesiologists contrast their practices with corporate models by pointing out that consolidation can reduce clinical autonomy. In national, private equity-backed groups, physicians have reported limits on scheduling flexibility, staffing decisions and a stronger focus on financial performance over clinical considerations.
These concerns are driving independents to position themselves as better able to safeguard provider decision-making and patient-focused care
4. Confronting pressures to give up equity or stipends: Independent anesthesia groups are being squeezed by rising costs and a limited supply of providers.
In some cases anesthesia groups are staying out of network or refusing cases unless ASCs make up the difference with stipends or equity.
5. Leveraging regulatory scrutiny of consolidation: Independent anesthesia groups are citing regulatory oversight as a counterbalance to consolidation pressures. The Federal Trade Commission recently reached a settlement with US Anesthesia Partners’ private equity backer that included restrictions on its role and required advance notice of future acquisitions. The action highlights increased scrutiny of anesthesia consolidation that could influence how the market evolves.
