The rapid expansion of ASCs is bumping up against a critical constraint: anesthesia staffing.
As ASCs take on more complex procedures, anesthesia coverage is becoming a key chokepoint — and for many centers, the inability to reliably staff anesthesiologists or certified registered nurse anesthetists is threatening schedules, margins and growth pipelines.
ASC operators report rising compensation demands and dwindling availability of anesthesia providers.
“The lack of anesthesia providers for ASCs in many markets will continue, and anesthesia compensation will continue to rise,” Adam Spiegel, CEO of NorthStar Anesthesia, told Becker’s.
In many markets, ASCs are forced to pivot to CRNA-only or hybrid anesthesia models to maintain operation.
The shortage isn’t just about wages. Burnout, demand for shift flexibility and competition from hospitals and locum agencies are compounding the issue.
“Today’s shortage of anesthesia providers has been compounding for years and has turned into an incredible challenge for all,” Andrew Lovewell, CEO of Columbia (Mo.) Orthopaedic Group, told Becker’s.
More than 40% of anesthesia professionals are considering leaving their roles in the next two years, citing workload and compensation pressures. Some centers have already been forced to close rooms or cancel cases when anesthesia personnel could not be secured.
This challenge is especially acute for ASCs attempting to move into more complex surgical lines.
Robotics, navigation systems and higher-acuity cases demand precise anesthesia support; gaps in coverage can delay or block those growth plans entirely.
Suburban or rural ASCs, already dealing with constrained labor pools, feel the pinch more sharply. To adapt, ASCs are experimenting with staffing alternatives: in-house anesthesia teams, contracting through temp agencies, cross-utilizing pain or sedation providers and reworking perioperative workflows to make demands leaner.
Some ASC administrators say they are even training registered nurses to perform procedural sedation in certain settings where allowed by state scope.
Nevertheless, the risk is real. Anesthesia staffing shortfalls can erode margins via higher labor costs, case cancellations and underutilized operating rooms. Anesthesia has been flagged as one of the most disruptive budget forces for ASCs in 2025. As regulatory and reimbursement pressures mount, centers that cannot stabilize anesthesia coverage may struggle to compete in the evolving outpatient surgery landscape.
