Anesthesia is at an inflection point: soaring demand, evolving technology and growing outpatient volume offer new opportunities, but workforce shortages, reimbursement pressure and increasing complexity threaten sustainability.
These five trends illustrate why anesthesia leaders say 2026 will bring both opportunity and serious headwinds:
1. Workforce shortages and burnout are pushing anesthesia models to their limits: The U.S. anesthesia workforce is under pressure: many anesthesiologists and CRNAs are nearing retirement, and demand is rising faster than training pipelines can deliver.
Nearly 30% of today’s anesthesiologists are projected to leave practice by 2033, creating a deficit at a time when surgical and procedural volume continues to expand. This shortage is prompting ASCs and health systems to rethink staffing models, rely more heavily on CRNAs and anesthesiologist-assistant teams, and reconsider how to balance volume, safety and provider well-being.
2. Technology and AI are increasingly shaping anesthesia care by offering efficiency and precision: 2025 has seen a surge in adoption of AI‐augmented anesthesia tools. From AI-driven decision support and real-time monitoring to smart scheduling, documentation and risk-prediction platforms, anesthesia care is becoming more data-driven and responsive.
New tools include AI-assisted ultrasound for regional anesthesia and automated pre-op risk stratification, enabling safer procedures, better workflow, reduced cancellations and more consistent outcomes.
For many practices, especially outpatient and ASC-based, these tools are increasingly a lifeline for maintaining quality and throughput, despite staffing and reimbursement constraints.
3. Outpatient and ASC-based anesthesia is growing, but complexity and cost pressures are rising, too: As more surgeries and procedures migrate to ASCs and outpatient settings, anesthesia demand in ambulatory care continues to climb.
At the same time, ASCs and anesthesia groups are balancing increasing case complexity, tighter margins, rising supply costs and the need for efficient staffing — all under the cloud of workforce shortages.
Growing outpatient volume offers an opportunity, if ASCs and anesthesia teams can successfully implement technological, staffing and operational innovations to manage the pressure.
4. New care models and staffing strategies are emerging as anesthesia workforce dynamics shift: The 2025 Somnia Labor Market Study shows anesthesia workforce preferences are undergoing a structural shift, with more clinicians seeking 1099 arrangements for flexibility and autonomy while others continue to value the stability of traditional W-2 roles. This is driving hospitals to adopt hybrid staffing models that combine employment security with lifestyle-aligned scheduling options, now a key differentiator in recruitment and retention.
The report also highlights a renewed preference for hospital-based practice, where structured workflows and collaborative teams support stability, and notes that leadership effectiveness has become a primary determinant of retention. Early-career clinicians demonstrate a growing openness to team-based care, signaling an evolution in how care models will be structured, moving forward.
5. Reimbursement pressure and a shift toward outpatient settings are reshaping anesthesia at the end of 2025: Some insurers have proposed or implemented caps on CRNA reimbursement at 85% of the physician fee schedule, adding financial strain for many anesthesia groups already managing tight margins.
At the same time, the continued movement of cases to ASCs and office-based settings is shifting where anesthesia services are most needed. Moreover, these trends are beginning to reshape competitive dynamics. In many markets, outpatient environments are gaining momentum and staffing appeal, while hospitals face increasing pressure as reimbursement challenges and site-of-care migration accelerate.