ASCs are already feeling the strain this fall as staffing challenges deepen beyond the well-documented nursing shortage. Rising case complexity, workforce burnout and reimbursement pressures are exposing new vulnerabilities in anesthesia, robotics support and specialized perioperative care.
Here are five things to know:
- Anesthesia workforce shortages: The anesthesia workforce is under acute strain. Provider shortages, reimbursement cuts and burnout are colliding with rising surgical demand, threatening OR efficiency and patient access — especially in rural areas. Many ASCs are shifting to CRNA-only or hybrid models to compensate.
“The lack of anesthesia providers for ASCs in many markets will continue, and anesthesia compensation will continue to rise. These two dynamics are at odds: fewer providers and more access needed,” Adam Spiegel, CEO of NorthStar Anesthesia, told Becker’s.
- Burnout and pay pressure in anesthesia: Reimbursement declines and increasing workload are driving burnout and turnover in anesthesia roles. More than 40% of anesthesia professionals are considering leaving their current roles within two years, citing work hours, administrative burden and compensation issues, according to an August report from the American Medical Association.
“The biggest challenge we face with anesthesia is the nationwide shortage of anesthesia staff,” Tina Driggers, administrator of DSC Day Surgery Center in Winter Haven, Fla., told Becker’s. “This leads to room closure and cancelling of cases which in turn ends up with economic stresses to the surgery center.”
- Technical staff for robotics and navigation: As robotics, navigation and advanced imaging grow more common in spine and orthopedic surgeries, ASCs will need staff who can support and maintain those systems. These roles are not just helpful — they’re foundational to expanding higher-acuity case volume.
- Specialized perioperative care: Beyond general OR and nursing roles, ASCs need perioperative specialists in spine, orthopaedics and cardiac support.
Staffing shortages in these specialties have been linked to procedure delays and workflow disruptions, particularly as more complex musculoskeletal and spine cases move outpatient.
5. Financial strain from staffing gaps: Shortages in anesthesia coverage drive up ASC costs in several ways, including higher provider pay, canceled cases, and reduced surgical volume. At the same time, rising labor expenses are contributing to a broader financial storm for ASCs, as shrinking reimbursements and inflation further erode already thin margins.
