Numerous legal, clinical and policy developments have shaped the anesthesia industry in 2025.
As staffing shortages, reimbursement issues and high operational costs persist throughout healthcare, five anesthesia leaders joined Becker’s to discuss the new and old challenges they’re anticipating in 2026.
Question: What’s your biggest anesthesia-related concern headed into 2026?
Editor’s note: Responses have been lightly edited for clarity and length.
Peter Bravos, MD. Chief Medical Officer of Sutter Health Surgery Center Division (Sacramento, Calif.): My biggest anesthesia-related concern heading into 2026 is maintaining stable coverage across our sites in an increasingly competitive Northern California market. Recruitment is difficult; compensation expectations keep rising, and even a single anesthesia vacancy can disrupt multiple centers. At the same time, anesthesia costs continue to climb while ASC margins stay tight, making it challenging to balance financial sustainability with consistent, high-quality staffing.
Brian Cohen, MD. Administrative Chief of Miami Anesthesia Services: My hope is that our ability to solve for and manage the staffing and cost crisis of 2024-2025 does not put us in a situation to become a forgettable asset in 2026. For example, normal blood pressure doesn’t mean you can stop the medicine…it means the medicine is working. The same logic applies here. Instead of continuing to be the problem, our industry has worked to find ways to be a partner in the solution.
When the system, however, believes that they can now do this independent of any collaboration with the anesthesia team, they are essentially stopping the blood pressure medication that has kept the system under control, forcing this cycle to start over again. My hope in 2026 is that we continue to move forward together and appreciate the impact of teamwork.
Brian Evans. Chief Operating Officer of Optim Health System (Savannah, Ga.): Reimbursement rates for anesthesia services continue to be well below the cost of providing care. Additional cuts will only worsen this issue, increasing the subsidies hospitals and ASCs pay anesthesia providers to ensure coverage.
Cory Koenig, DO. Vice President of Operations at Providence Anesthesiology Associates (Charlotte, N.C.): Our biggest concern in the state of North Carolina is preparing for and dealing with the repeal of the previous [certificate-of-need] laws. We expect a major disruption in the current operations which could result in major inefficiencies and poor OR utilization as cases migrate to new ASCs. Beyond that, it is the continued downward trends of anesthesia reimbursements by both government and private payors.
Charles “Chuck” Tabbert, CRNA. Anesthesia Department Chief at Mercy Health – Defiance (Ohio) Hospital: My biggest anesthesia concern heading into 2026 is safeguarding access to anesthesia care in our rural and community hospitals as patient complexity rises and system capacity tightens. These hospitals are managing sicker patients with fewer resources while payers add financial pressure that strains margins and limits flexibility. Our responsibility as leaders is to build resilient systems—strong pre-anesthesia pathways, data-driven optimization, and staffing models tailored to our facility partner that prioritizes efficient anesthetic delivery over redundancy – ensuring [certified registered nurse anesthetists] are deployed to their full capacity. If we get that right, we ensure patient safety, preserve access, and keep our surgical and obstetric services viable.