As anesthesia groups prepare for 2026, pressures from reimbursement cuts, workforce shortages and rising operational costs are intensifying.
Here are five data points fueling concern about the year ahead:
1. Anesthesia compensation is declining in real terms: CMS’ 2025 anesthesia conversion factor decreased by 2.20%, continuing a multiyear erosion of reimbursement that has reduced average anesthesia payment from $22.27 per unit in 2019 to $20.44 in 2024. As inflation and operating costs rise, this decline means anesthesiologists are effectively earning less in real terms each year.
2. A growing share of anesthesia professionals are dissatisfied and considering leaving the field: Anesthesiologists and CRNAs find themselves confronted with rising clinical demands, heavier call schedules, and expanding perioperative responsibilities that have not kept pace with reimbursement trends or practice resources. More than 40% said they were considering leaving their current roles within the next two years.
3. The national anesthesia workforce shortage worsens: Recent projections indicate that by 2036, the country will be short 6,300 anesthesiologists, and 56.9% of currently practicing anesthesiologists are already over age 55.
Without restructuring, anesthesia groups will likely struggle to fill staffing gaps, maintain OR coverage and support expanding ASC case volumes.
4. Reimbursement erosion and payer pressure intensify: Anesthesia groups report mounting financial pressure as CMS reimbursement cuts compound with increasingly aggressive commercial payer policies, resulting in lower allowable rates, more denials and growing administrative burdens.
This ongoing erosion challenges anesthesia practices, which must absorb rising staffing, technology and overhead costs while reimbursement lags behind demand.
5. Consolidation and contracting volatility are reshaping anesthesia practice models: Hospital systems and large national anesthesia groups continue to consolidate the specialty, creating competitive pressure and reducing leverage for independent practices.This consolidation has created more volatility in service-line contracting, with some hospitals and ASCs shifting providers or renegotiating terms more frequently, which in turn heightens uncertainty for anesthesia groups.