For independent anesthesia groups, the market has increasingly presented two exits: sell to a private equity-backed national group or become hospital employees. A small number of practices are testing a third path.
Copractica, a Dallas-based clinically integrated network built specifically for anesthesia, aggregates independent practices under a single tax ID for billing and payer contracting without buying or controlling them. The network includes 11 practices and about 400 providers across Texas, with plans to expand out of state.
CINs are a well-established mechanism for health systems, which use them to aggregate primary care practices, but the model has rarely been applied to a single specialty. According to a 2023 article posted in the National Library of Medicine, 35% of hospitals participated in a CIN in 2019, with larger, not-for-profit and metropolitan hospitals more likely to participate.
“That’s why we did it as a CIN, — we didn’t want to buy and own and control, we wanted to just aggregate and support,” Stan Morton, CEO of Copractica, told Becker’s.
The independent landscape these groups are trying to preserve is shrinking fast. As of January 2026, 82% of U.S. physicians were employed by hospitals or corporate entities, according to an Avalere Health analysis commissioned by the Physicians Advocacy Institute, leaving about 120,900 physicians in independent practice.
Anesthesia consolidated faster than most specialties. Groups owned by private equity or publicly traded companies grew from 3.2% of the national anesthesia market in 2009 to 18.8% by 2019, according to a Health Affairs Scholar analysis, and each of the five largest independent anesthesia practices in 2009 was acquired over that decade.
Why groups join
The network’s early members were mid-sized groups of 20 to 30 providers, Mr. Morton said, often run by physician leaders managing the business on nights and weekends without professional infrastructure. Joining the CIN gives them scale purchasing, back-office support and a seat at the table with payers that a 20-provider group could not command on its own.
Groups retain full control of clinical decisions, including which facilities they cover, which surgeons they work with, and whether they run a physician-only or care team model, he said.
Courtney Gonzalez, Copractica’s operations administrator, came to the network from a PE-backed consolidated anesthesia group and said the CIN borrows what worked about consolidation while stripping out the rest.
“We looked at what worked in the consolidated market — how do we take off the bankers? How do we take away the disconnect from the communities that are local, and then still be able to have this synergy opportunity that protects the independent practice?” she said.
Erik Hemingway, CFO at Copractica, pointed to cost structure as the fundamental difference from the PE model.
“There’s no Wall Street payment off the top, right? There’s no unnecessary cost layer,” he said. He added that independent groups keep control over compensation, deciding how to divide pay among physicians based on the work being done.
The share of ASCs expecting to pay anesthesia stipends jumped from 28% in 2024 to 44% in 2025, according to a VMG Health report, a 57% increase in a single year. Additionally, 60% of ASC leaders ranked anesthesia coverage among their top three financial challenges for 2026, making it the most commonly cited operational concern heading into the year.
A 2020 study published in JAMA Network found that roughly 20% of anesthesia practices had been acquired through PE physician practice buyouts. By 2024, that share had grown to approximately 33%, according to AMGA Consulting’s analysis. Dallas-based U.S. Anesthesia Partners, one of the largest PE-backed anesthesia platforms, now employs approximately 5,000 clinicians nationally. The pricing effect followed quickly. Chicago Booth Review reported in 2025 that anesthesia prices rose 25% to 30% within two years of the uptick in PE acquisitions in the specialty.
“There’s nothing more unnerving than feeling like your back’s against the wall, and having to choose between two options you don’t like,” Mr. Morton said.
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