When Chicago-based Midwest Anesthesia Partners lost a major hospital contract in 2024, the company reshaped its strategy — a pivot that doubled its ASC contracts and reinforced its commitment to independent practice.
Marco Fernandez, MD, president of Midwest Anesthesia Partners, told Becker’s group’s experience illustrates both the challenges and opportunities anesthesia groups face amid consolidation, workforce shortages and reimbursement issues.
In early 2024, 37 anesthesiologists suddenly found themselves without a hospital contract. Instead of disbanding, most merged to form Chicago Anesthesia Leaders, a subdivision of Midwest Anesthesia Partners.
“We didn’t want to be a typical locums group,” Dr. Fernandez told Becker’s. “We have ties to the community and wanted to leverage the relationships we’d built over time.”
The group built a hybrid model that is made up of 80% ASC contracts and 20% hospital locums coverage. Within months, ASC contracts had doubled as surgeon partners sought stable, relationship-based coverage instead of rotating staffing firms.
Independent anesthesia groups across the country have faced mounting pressure from both private equity and hospital employment models. In Illinois, staffing challenges are compounded by the state’s nearly one-to-one physician-to-CRNA ratio, a contrast to the four-to-one model many health systems prefer, according to Dr. Fernandez
“Chicago is the ‘wild west,’” Dr. Fernandez said. “Hospitals want to employ all anesthesia providers, but there’s still room for physicians and CRNAs to work in the way they feel is best.”
For Midwest Anesthesia Partners, independence isn’t only about contracts, it’s about professional autonomy and building practices that put both patients and clinicians first.
The group also sought to differentiate itself by expanding value beyond the OR.
“ASCs are smaller and more nimble, and it’s easier to partner with people at a smaller center. That’s where our value proposition comes through,” he said. “With so many rapid changes, we saw an opportunity to partner and ask, ‘What can we do outside the OR to provide value for our surgeon partners?'”
Years earlier, Midwest Anesthesia Partners had developed a perioperative surgical home model for orthopedic surgery, incorporating ERAS protocols and patient optimization strategies.
“Instead of rushing patients through pre-op, we worked with surgeons, nursing, PT, and pharmacy to schedule cases further out and optimize patients before surgery,” Dr. Fernandez explained. “That improved outcomes and built trust.”
By adapting that model to ASCs, the group positioned itself as more than a clinical coverage solution, instead becoming a partner in efficiency and patient outcomes.
Sustainable growth, Dr. Fernandez said, depends on aligning with the right partners.
“Every organization has people, process, and profit,” Dr. Fernandez said. “If it’s just about profit, someone will eventually be unhappy and leave.”
