The U.S. is projected to be short 6,300 anesthesiologists by 2036 and 12,500 CRNAs by 2033, according to a 2025 Medicus Healthcare Solutions white paper, and the strain is not spread evenly.
Here are five groups absorbing much of the pressure:
1. Rural hospitals. Rural facilities spread fixed anesthesia costs across fewer patients and serve higher shares of Medicare and Medicaid beneficiaries, Jeremie Perry, MD, chair of the American Society of Anesthesiologists’ Committee on Rural Access to Anesthesia Care, wrote in an Aug. 26 Becker’s column. CRNAs make up more than 80% of anesthesia providers in rural counties, and 78% of rural facilities report CRNA staffing gaps, according to ASA workforce research. Single- and dual-provider facilities risk losing surgical services entirely when one clinician leaves.
2. Small and independent ASCs. Without hospital-level resources, independent centers face a major strain, anesthesia leaders told Becker’s. The share of ASCs expecting to pay anesthesia stipends rose from 28% in 2024 to 44% in 2025, and 67% of ASCs rank anesthesia coverage among their top three financial challenges for 2026, according to VMG Health data.
3. Multisite operators. Peter Bravos, MD, CMO of Sutter Health’s surgery center division in Sacramento, Calif., told Becker’s that for multisite centers, “even a single anesthesia vacancy can disrupt multiple centers.” He said Northern California recruitment is competitive, with compensation rising while margins stay tight.
4. GI, catheterization labs and other non-OR sites. Endoscopy suites, catheterization labs and other non-operating room anesthesia locations face volatile demand for coverage, Megan Friedman, DO, chair and medical director at Los Angeles-based Pacific Coast Anesthesia Consultants, told Becker’s. Low-margin service lines face reduction or closure when coverage runs short.
5. Anesthesia clinicians. Half of anesthesiologists report burnout or depression, and 40.6% plan to leave within two years, the highest share among physician specialists, according to data from the American Medical Association. Nearly 57% are 55 or older. Payers are adding pressure: UnitedHealthcare cut reimbursement for CRNA services billed with the QZ modifier by 15% in selected states in October 2025.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
