Anesthesia staffing shortages and rising cost pressures are forcing ASCs to compete harder for providers and rethink how to keep teams stable over the long term.
At SCA Health, Optum’s ASC arm, leaders say retention is driven by a focused set of strategies, including a strong outpatient work experience, clinical autonomy and flexible scheduling models that make ASC practice sustainable for anesthesia professionals.
Compared with hospitals, ASCs often offer predictable hours, lower-acuity cases and a collaborative culture. That combination, SCA leaders told Becker’s, provides a built-in recruitment and retention advantage, particularly for CRNAs.
Stephanie Perna, regional vice president of operations for Kentucky, described the ASC value proposition as especially strong in today’s competitive market.
“SCA Health’s ASCs offer a compelling value proposition for anesthesia providers, particularly CRNAs,” she said. “The ASC environment provides predictable hours, lower acuity cases and a collaborative culture — all of which contribute to a better work-life balance.”
Retention, Ms. Perna said, also depends on empowering clinicians to practice to the top of their license. At SCA centers, CRNAs plan workflows independently and are embedded in annual education and competency programs, including emergency airway management, rapid response protocols, malignant hyperthermia drills and lidocaine toxicity training.
Culture plays a parallel role. Ms. Perna told Becker’s that at her center, CRNAs are actively involved in emergency drills and workflow planning.Additionally, Owensboro Surgery Center uses a self-scheduling model that allows CRNAs , including per diem staff, to plan weeks or months in advance.
According to Ms. Perna, that approach stands out in a market where CRNAs often receive eight to 10 weeks of PTO. The ability to plan work around personal time, while operating in a controlled outpatient environment, has become a meaningful driver of satisfaction and retention.
“The ability to proactively align work with personal time, while operating in a controlled, high-functioning environment, has been a key driver of satisfaction and retention,” she said.
SCA leaders also frame retention as inseparable from the way anesthesia is integrated into overall operations. Lindsay Lowder, group vice president of operational strategy and innovation, said the system views anesthesia “not as a transactional service, but as a strategic partner in delivering safe, efficient and patient-centered care.”
Operationally, that partnership translates into smoother scheduling, reduced overtime and regional support teams to stabilize coverage, she said.
SCA is also “expanding direct and centralized employment models at more locations to keep staffing steady, rely less on temporary providers and improve alignment between anesthesia teams and center operations.” In markets where employment isn’t feasible, SCA prioritizes long-term partnerships with “trusted anesthesia groups.”
Looking ahead, SCA Health plans to continue expanding direct employment of anesthesia providers across more sites as a way to deepen alignment and improve operational consistency.
“This strategic shift strengthens coordination, accountability and alignment with center operations, ultimately leading to smoother workflows and better patient experiences,” Ms. Lowder said.
