Anesthesia coverage has quietly moved from a scheduling detail to a strategic question, one that ASC administrators, surgeons, and anesthesiologists say will define which surgery centers grow and which ones stall over the next five years.
From stipends becoming standard to CRNA reliance accelerating, 24 ASC leaders, administrators and physician partners joined Becker’s to discuss how they expect anesthesia coverage models at their ASC to change in the next five years
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Editor’s note: Responses have been lightly edited lightly for clarity and length.
Question: How do you expect anesthesia coverage models at your ASC to change over the next five years?
Jason Acevedo, MD. President of Elm Place Ambulatory Surgery Center and Otolaryngologist at West Texas Ear, Nose & Throat (Abilene): Regarding anesthesia coverage models at my ASC, I do not anticipate significant changes over the next five years. We have operated successfully as a CRNA-staffed facility and have consistently maintained high standards of quality and safety without the added financial pressures associated with MD anesthesia. Unless compensation structures shift meaningfully, I expect most ambulatory surgery centers to continue moving toward CRNA-driven models.
We have been fortunate to build a highly collaborative relationship with our nurse anesthetists, with stipends tied to shared performance metrics. They have a vested interest in the success of our center and have demonstrated a willingness to partner with us to deliver excellent care at the most sustainable cost.
With rising inflationary pressures and flat reimbursements, every ASC must evaluate its cost centers and determine how to allocate resources most effectively. Whether sedation is administered by an RN, or anesthesia is provided by CRNAs or MD anesthesiologists, each role must add value to the center. To remain financially viable, we must all focus on delivering safe, high-quality care at the best possible cost.
Vijay Bachani. President and Chief Growth Officer of New York Bariatric Group (Roslyn Heights, N.Y.): In the Northeast, regulations still require physician supervision of CRNAs, and New York hasn’t opted out, so the independent CRNA model that saves money in other states doesn’t apply here. We’ll keep running a mix of employed anesthesiologists, per diem, and locums, and I don’t see that changing much. Where it makes sense, like our ASC in Arkansas, an opt-out state, we’ll continue to use CRNAs.
The bigger shift I’m watching is on the payer side. Payers are coming after ASCs that allow out of network providers, including anesthesia, sometimes by terminating the facility contract outright. Combined with the pressure from the No Surprises Act and [independent dispute resolution], that’s pushing everyone toward in-network arrangements, where facility subsidies are becoming table stakes. The weaker your payer mix, the more of the coverage cost you end up underwriting.
Basil Besh, MD. Orthopedic Surgeon and Founder of Fremont (Calif.) Orthopaedic and Rehabilitative Medicine Hand, Wrist and Elbow Institute: Declining anesthesia reimbursement has forced an increasing number of ASCs to underwrite coverage through substantial facility stipends, directly eroding profit margins and compressing distributions for partners. To offset this financial strain, market dynamics dictate a necessary shift toward anesthesia extenders like CRNAs to maintain operational viability. CRNAs represent an ideal structural fit for the ambulatory environment, given that elective surgery center patients inherently present a much lower medical acuity from an anesthesia standpoint, allowing for safe, highly efficient throughput without the unsustainable overhead of a physician-only model.
Peter Bravos, MD. Chief Medical Officer of Sutter Health Surgery Center Division (Sacramento, Calif.): Anesthesia coverage has shifted from an operating expense to a strategic investment, and it is now the primary constraint on ASC growth.
Care models are moving toward flexible coverage that can combine physicians, CRNAs or hybrid teams, matched to the acuity and throughput of each setting. The differentiator is not a fixed staffing ratio but clear accountability for patient safety, especially when a routine case escalates without warning.
The economics have changed just as fundamentally. Workforce shortages and rising compensation have opened a structural gap between professional revenue and the cost of dependable coverage, and that gap is here to stay. Thus, the defining question is no longer what coverage costs, but who bears the reliability risk. That answer belongs in the financial model from the start.
Surgical growth now moves at the speed of the coverage behind it. The organizations that win will align workforce strategy, operational discipline, and financial planning. They will be measured not by lowest cost, but by their ability to deliver consistent access and safe, predictable care.
Charlene Cioe, MSN-APN, CNO. Summit Center for Surgery (Oakbrook Terrace, Ill.): Anesthesia coverage will remain a challenge for ASCs over the next five years. Workforce shortages aren’t going away, so we’ll likely continue to see an increase in the use of CRNAs working alongside anesthesiologists in team-based models. The goal will be to maintain access to quality anesthesia care while balancing rising costs.
I also think many ASCs will continue to feel pressure around anesthesia stipends, particularly in markets where recruiting and retaining providers is difficult. As more complex spine procedures move to the outpatient setting, anesthesia teams will become even more important partners in patient selection, safety, and operational efficiency. Centers that can build strong, collaborative relationships with their anesthesia providers will be best positioned to succeed.
Anesthesia stipends are likely to remain part of the ASC landscape for the foreseeable future. The bigger issue is how centers manage those costs as labor expenses continue to climb. ASCs will need to work closely with their anesthesia partners to develop coverage models that support patient care while remaining financially viable.
We’re continuing to see more complex cases move to ASCs, which places greater demands on anesthesia teams. Anesthesia’s role is becoming increasingly important in helping centers deliver safe, efficient care. The organizations that do this well are those in which surgeons, anesthesia providers, and administrators are aligned and working toward the same goals.
There is no perfect anesthesia coverage model. What works in one market may not work in another. The key will be finding an approach that ensures consistent coverage, supports patient care, and remains sustainable for both the ASC and the anesthesia team.
Daniel Decker, MD. Co-Founder of Vitality Plus Urology Clinic (Mountain Home, Ark.): Over the next five to seven years, we envision a significant change to anesthesia coverage models. As cost and demand for anesthesia continues to rise, it likely cannot be curtailed by simple cuts without a subsequent drop in quality/safety. ASCs will also likely continue to expand in higher acuity surgeries and in the volume of lower acuity procedures. Besides the traditional anesthesia provider roles, a new revenue stream may develop as ASCs ideally transform to a healthcare hub and spoke model.
For example, the anesthesia provider is critical in the evolving incorporation of AI tools for patient communication, smart imaging and optimization of various pre/intra/post op processes, along with streamlining the PST protocols utilizing telemedicine anesthesia consults and remote biometric monitoring. From this ASC transformation, a healthcare hub may ensue and expand spokes into preventative care, precise diagnostics, expedited consult referrals, etc. ASCs would then become a scalable healthcare delivery system that could continue to improve quality at lower costs.
The MD anesthesia/CRNA becomes a critical contributor with valuable insight in the development and incorporation of these provider extender and efficiency tools. This will not only improve quality and volume but open up a new revenue stream for ASCs and anesthesia providers. Taken further, it could help establish a platform for value-based care revenue.
Overall, ASCs may lead in a significant and needed transformation of healthcare delivery modernization in the US with anesthesia providers efficiently expanding their scope of care and vital role.
Jack Dillon. Chief Executive Officer of Anesthesia Practice Consultants (Grand Rapids, Mich.): Over the next five years, I expect anesthesia coverage models at ASCs to become more flexible, more expensive and more strategically important. The traditional assumption that anesthesia coverage will simply be available without financial support is becoming less realistic, particularly in markets where CRNA and anesthesiologist supply remains constrained.
I expect more ASCs to move toward blended staffing models that use anesthesiologists, CRNAs and CAAs more deliberately based on case mix, payer requirements and healthcare expectations.
Financial structures will also continue to evolve. Rather than broad subsidies, ASCs and anesthesia groups will likely move toward more defined support models tied to room coverage, guaranteed hours, underutilized blocks, and staffing expectations. In many cases, the issue is not whether a stipend exists, but whether the structure clearly aligns incentives between the facility, surgeons and anesthesia providers.
The biggest pressures I am watching are workforce supply, reimbursement compression, ASC case migration, increasing expectations around access and efficiency, and the cost of maintaining reliable daily coverage. ASCs that want dependable anesthesia coverage will need to treat anesthesia as a strategic partner, not just a scheduled service.
Alyson Engle, MD. Director of Pain Medicine and Neuromodulation at Illinois Orthopedic Network (Chicago): We have found AAs to be superior to CRNAs and a cost effective alternative. Anesthesia assistants have provided exceptional care and take more direction from anesthesiologists.The availability of AAs as alternatives to CRNAs has been fiscally helpful while adhering to more physician level care.
Sean Gipson. CEO and ASC Division President of Remedy Surgery Center (Houston): Over the next five years, I expect ASC anesthesia coverage models to become increasingly CRNA-centric, driven by ongoing workforce shortages, rising provider compensation and continued pressure on reimbursement rates. While anesthesiologists will remain essential for leadership, oversight, and higher-acuity cases, many ASCs will rely more heavily on anesthesia care team models that maximize CRNA utilization while maintaining quality and patient safety. Quite frankly, I see that happening across all of medicine be it ASC or even hospitals.
Another unfortunate yet significant trend will be the continued growth of anesthesia stipends and coverage guarantees. What was once viewed as a temporary response to staffing challenges is becoming a permanent component of ASC financial planning. As hospitals continue to compete aggressively for anesthesia providers, ASCs will need to offer increasingly competitive arrangements to ensure reliable coverage.
I am also watching operational efficiency closely. Facilities with strong block utilization, predictable case volumes, and efficient turnover times will be in a much stronger position to manage anesthesia costs than centers with inconsistent scheduling patterns. Ultimately, the most successful ASCs will be those that develop collaborative anesthesia partnerships, optimize staffing models, and proactively address the financial realities of a constrained anesthesia workforce.
Megan Friedman, DO. Chair and Medical Director of Pacific Coast Anesthesia (Los Angeles): Workforce availability will remain the primary pressure. Regardless of the model, whether physician-only, care team or hybrid, ASCs will need coverage aligned with room utilization, case complexity and growth plans. More centers will assess staffing not just by volume, but by the level of clinical complexity they intend to support.
Stipend structures will also become more common and transparent. Historically, anesthesia groups absorbed inefficiencies such as late starts, underutilized rooms, fragmented schedules, cancellations and add-ons. That model is no longer sustainable. Reliable coverage requires alignment between scheduling discipline, block utilization and financial support.
As patient acuity continues to increase in the ASC setting, I also expect greater emphasis on long-term clinical partnerships rather than transactional coverage models. High-quality perioperative care requires providers who understand the facility, participate in quality initiatives, help develop protocols, and are integrated into escalation pathways when clinical issues arise. Anesthesia groups that are engaged in the broader operations of the center will be better positioned to support increasingly complex patients safely and efficiently.
Most importantly, operational alignment will define success. ASCs that engage anesthesia as a strategic partner, rather than simply the last group asked to cover rooms, will be better positioned for sustainable growth.
Bruce Feldman. Administrator of Bronx Ambulatory Surgery Center (New York City): I expect that there will be more collaborative type agreements between anesthesiologists/CRNAs and ASCs as the anesthesia shortage gets worse. ASCs need to begin viewing anesthesiology no longer as a service line/commodity but rather as a partner no different than how they view their surgeon investors. Having equity arrangements instead of paying stipends will become the norm.
Aaron Hayes. Administrative Director of North Pointe Surgery Center (Lancaster, Pa.): Our ASC is in a somewhat unique position because we directly employ our anesthesiologist and CRNAs. That model has given us a high degree of control over who provides care, how many ORs we can reliably cover each day, and, to some extent, the cost structure of the anesthesia department. However, it does not make anesthesia inexpensive. While we are not paying a stipend to an outside anesthesia group, we are still carrying wages, benefits, CME, malpractice, recruitment risk and the operational burden of maintaining coverage.
Over the next five years, I expect anesthesia coverage to remain one of the most significant financial and operational pressures facing ASCs. Demand for anesthesia coverage is increasing as more cases migrate to the outpatient setting and new ASCs continue to open, but the supply of anesthesiologists is not keeping pace. I do not see that imbalance being corrected quickly.
In our state, a CRNA-led model is not available in the same way it is in some other markets. Even if it were, I think our surgeon owners would be cautious about moving away from an anesthesiologist-led model, particularly given the complexity of orthopedic cases and the perceived safety concerns around higher-acuity outpatient procedures. For that reason, I do not expect a dramatic shift in our CRNA-to-anesthesiologist mix. I do, however, expect continued pressure to use each provider at the top of their license, optimize staffing by daily case mix, and avoid paying for underutilized anesthesia capacity whenever possible.
The larger issue is that anesthesia has become essential infrastructure for an ASC. It is as critical as electricity. You cannot run the OR without it. Yet the reimbursement for professional anesthesia services often does not cover the true cost of providing that coverage. That creates a structural problem: ASCs need anesthesia to generate facility revenue, but the anesthesia service line itself may not be financially self-sustaining.
I think ASC leaders will increasingly need to stop looking at anesthesia only as a separate profit center or cost center. Payers are evaluating total reimbursement, not necessarily the internal buckets we use between facility, professional, and anesthesia revenue. As contracts come up for renewal, the focus should be on improving total case economics rather than preserving arbitrary distinctions around where the anesthesia reimbursement sits.
In short, I expect anesthesia coverage to remain tight, expensive, and strategically important. Whether an ASC employs its anesthesia team, contracts with a group, or pays a stipend, the underlying issue is the same: reliable anesthesia coverage is becoming more difficult to secure, and ASCs will need to account for that reality in payer negotiations, case selection, block utilization, and long-term growth planning.
Thomas Jeneby, MD. CEO of Palm Tree Surgicenters, Chrysalis Cosmetic Surgicenter and Maximus Plastic Surgicenter (San Antonio): This is the billion dollar question and is not easy. Do you over-hire for high utilization times? Do you under-hire to accommodate 6 months out of the year and use a group? It depends on volume and seasonality. In plastic surgery the second and fourth quarters are busiest and the first and third quarters are flat. So if we find the right people: Some in the bench want full time, some want part time, some want PRN — we obviously would like as few full time employees to not get overburdened by salary for 6 months of reduced cases and be able to add in part-time/PRN for busier months. Not easy and no good answer.
Maher Kodsy, MD. Chair of the Department of Anesthesiology and Perioperative Physician Director at University Hospitals Elyria (Ohio) Medical Center: Currently, certified registered nurses anesthetists outnumber anesthesiologists, which positions CRNAs in a favorable market position. State regulators may be compelled to either eliminate mandatory supervision for CRNAs or increase the supervision ratio to exceed 1-to-4.
The number of CRNA training programs is increasing, while the number of anesthesiologists is not keeping pace with demand. Consequently, the market may become saturated with CRNAs in the near future. With the narrowing compensation gap between CRNAs and anesthesiologists, ASCs may have the opportunity to selectively choose providers.
In tandem with the increasing number of CRNAs, there is a parallel increase in the number of Certified Anesthesia Assistance. This could mitigate some of the volatility and alleviate the financial burden associated with the lower supply.
Over the next 5 to 10 years, the market may reach a steady state. There will be no elimination, but rather more collaborations. The rate-limiting factor in subsidies is the CMS unit conversion value. As long as CMS continues to pay less than 20% of the provider’s actual compensation, ASCs will continue to subsidize anesthesia services. ASCs do not receive the same governmental financial assistance as hospitals and healthcare systems nationwide. If they continue to offer subsidies for anesthesia services rendered, their profit margins will continue to decline.
The solution does not lie in competing with other facilities to attract providers from the same pool, which is becoming increasingly limited. Furthermore, the anesthesia societies failed to persuade CMS to compensate anesthesia services at their fair market value. It appears that medical societies operate independently and in parallel, each operating within its own sphere. The solution should address the problem at its source through a collaborative effort of the entire medical community, not solely the anesthesia societies. Healthcare systems act as intermediaries for CMS/government to subsidize anesthesia services. By eliminating brokerage expenses and compensating anesthesia services at their fair market value directly, cost savings will be realized for all parties involved.
In summary, the expectation of ASCs anesthesia services will continue to suffer turbulence as long as CMS persists the far below fair market valuation. A unity of various professional organizations to address the challenges is required than ever before seeing more ASCs close their doors or filing for bankruptcy.
Jessica Lam, PhD. Practice Manager at Pacific Coast Anesthesia (Los Angeles): I expect anesthesia coverage models in ASCs to become increasingly focused on workforce sustainability and operational predictability.
The days of simply finding a provider to cover a room are largely behind us. Recruiting and retaining anesthesia professionals has become significantly more competitive, which means ASCs will need to think more strategically about scheduling, work-life balance, coverage expectations, and long-term provider engagement.
I also anticipate continued growth in stipend support and other financial arrangements designed to ensure consistent coverage. As anesthesia labor costs rise, facilities and anesthesia groups will need greater transparency around the true cost of maintaining reliable staffing. Successful partnerships will be built on shared accountability for efficiency, schedule management, and resource utilization.
Technology will also play a larger role. More organizations will leverage workforce management tools, predictive scheduling, and data analytics to better align staffing with demand, reduce overtime, and improve provider satisfaction.
From my perspective, the most successful anesthesia programs will be those that prioritize retention as much as recruitment. Creating a stable, engaged workforce reduces turnover, improves operational consistency, and ultimately benefits both the facility and the patients it serves.
Andrew Lovewell. CEO of Columbia (Mo.) Orthopaedic Group: Over the next five years, I expect ASCs to keep pushing towards finding the correct coverage models for routine cases. In some markets, that may be a CRNA-focused approach. It may also vary dramatically by speciality. For example, in orthopedics, the traditional anesthesiologist model may continue to reign supreme. Flat stipends are dying; there are already negotiations ongoing that head toward volume-tied performance and high acuity patients. I am also watching the market and keeping an eye on anesthesia group stability. A couple of larger failures or retraction in the marketplace has some people on edge. Another major issue is the CRNA wage inflation, if this doesn’t cool off some, you’ll see more ASCs/practices explore W-2 employment like our practice did well over 2 years ago.
Paul Lynch, MD. Founder and CEO of US Pain Care: Let me share our strategy at US Pain Care. As CEO — and a board-certified anesthesiologist — knowing how big this issue has become, and seeing some of the stipends we’ve. When paying for anesthesia coverage, I’ve agreed to fly all around the country and personally do the anesthesia at every one of our centers, every day. Problem solved.…In all seriousness, this is one of the hardest operational challenges we face.
The answer: With anesthesia in lower supply every year since COVID, I think bringing it in-house is the answer — full-time employment with your own CRNAs or anesthesiologists rather than subsidizing an outside group. And as a pain-first ASC, more of our volume is moving to nurse-administered moderate sedation where it’s clinically appropriate and the state allows it — and let me be clear, patient safety and ASA status draw that line, not the budget.
On the contracts themselves, base salary with a productivity bonus is a great way to set these up. And if you go this route, make sure your billing company has real experience billing anesthesia — it’s tricky, and that’s where a lot of centers get burned.
Taif Mukhdomi, MD. Interventional Pain Physician at Pain Zero (Columbus, Ohio): In the interventional pain space, I anticipate a shift toward minimizing or eliminating the routine use of anesthesia services, with greater emphasis on setting patient expectations regarding local anesthetic use and, when appropriate, limited anxiolysis. This approach may also need to be incorporated into training programs to better prepare new graduates for a more efficient and sustainable practice model.
Anesthesia remains essential for major surgical procedures and is often viewed as a necessary operational expense, particularly because anesthesia services are generally not separately reimbursed well in ambulatory surgery centers (ASCs). While many surgical specialties rely heavily on anesthesia support, interventional pain and spine procedures are comparatively less invasive, more targeted, and typically associated with lower levels of procedural discomfort.
The vascular and interventional radiology fields have adopted a similar philosophy, which may create opportunities for meaningful collaboration within a multidisciplinary ambulatory surgical center.
Kathy Meccia, RN. Administrator of Lake George Surgery Center (Fremont, Ind.): We use a CRNA model for our ASC; with good quality CRNA’s you can run a high quality anesthesia department “affordably.” Anesthesiologists are just too expensive for the average ASC. We continually pay stipends on our CRNA model now, I could not imagine how we could survive with an MDA model.
Lauren Phillips. Administrator of The Cardiac & Vascular Institute Ambulatory Surgery Center (Gainesville, Fla.): Our ASC currently does not utilize anesthesia services, as our Registered Nurses provide conscious sedation for patients undergoing procedures. However, with the addition of Electrophysiology (EP) Ablation procedures to our ASC service line this year, we are in the process of implementing Certified Registered Nurse Anesthetist (CRNA) and anesthesia services specifically for these cases.
As outpatient cardiovascular procedures continue to expand and more complex procedures are approved for the ASC setting, I believe the need for anesthesia services will become increasingly prevalent. Additionally, as more ASCs open and compete for specialized healthcare professionals, securing consistent anesthesia coverage may become more challenging.
Cost is undoubtedly a significant factor when considering the addition of anesthesia services in an ASC. The financial impact affects not only the surgery center but may also influence overall healthcare costs for patients. Despite these challenges, I believe there are substantial benefits to incorporating anesthesia providers into the ASC environment.
Many patients undergoing procedures in the outpatient setting are medically complex and may not always be straightforward candidates. Having a skilled anesthesia team available enhances patient safety, improves procedural efficiency, and provides an additional layer of expertise for managing unexpected situations. Their presence contributes to a smoother experience for both the procedural team and the patient, ultimately supporting high-quality care and positive patient outcomes.
As cardiovascular and electrophysiology procedures continue to migrate to the outpatient setting, anesthesia services will likely become an increasingly important component of ASC operations and patient care delivery.
Stanford Plavin, MD. Owner of Oral Surgery Anesthesia Associates (Atlanta): The models have shifted dramatically and the financial pressures as well. Our practice/s offer a diverse array of staffing models which can provide physician anesthesiologists/CRNAs and hybrid/care team options. We have different staffing models at our various ASCs where we provide anesthesia care. The payer mix and the case mix tend to determine the model provided.
As referenced by many in the ASC realm, the provision of a stipend/revenue guarantee model is very common. This especially holds true to practices that are heavily weighted towards Medicare and other government payers which hit anesthesia providers the hardest.
While physician recruitment is still a challenge, the continued pressures of compensation have leveled off a bit. Of note, the traditional gap in compensation between physician providers and advanced practice nurse professionals has narrowed. The value proposition is shifting in many ways towards risk mitigation with physician centered care, especially in sites where there is an aging, complex and ever changing patient population.
Raghu Reddy. Chief Administrative Officer of MiOrtho Surgery Center and Secretary of the board of Ambulatory Surgery Center Association (Southfield, Mich.): The biggest change I see is a continued shift toward a care-team model, with greater reliance on CRNAs for day-to-day room coverage and anesthesiologists focused on medical direction, higher-acuity cases, regional blocks, complex total joints, spine, pediatric or higher-risk patients, and overall clinical governance. I do not think the anesthesiologist disappears from the ASC model, but I do think the ratio and deployment will become more deliberate.
From a stipend standpoint, I expect the days of “free anesthesia coverage” to become less common, especially for ASCs with variable volume, inefficient block utilization, late cancellations, or heavy add-on expectations. Anesthesia groups are going to want some combination of:
1. Guaranteed daily coverage payments;
2. Room-hour minimums;
3. Call or add-on stipends;
4. Medical director stipends or
5. Performance-based subsidy models tied to utilization, quality and coverage reliability.
For MiOrtho, I would not view a stipend as automatically unreasonable. The key is that any subsidy has to come with clear expectations. If we are financially supporting anesthesia coverage, then we should expect reliable room coverage, flexibility for trauma and add ons, consistent regional anesthesia capabilities, surgeon satisfaction, patient safety metrics, on-time starts, and participation in operational improvement.
The pressure points I would watch closely are:
- CRNA and anesthesiologist labor supply. Hospitals, health systems and national anesthesia groups are competing aggressively for the same providers. ASCs will need to be attractive places to work: predictable days, efficient rooms, low drama, strong surgeons and no unnecessary downtime.
- Block utilization. Anesthesia coverage will increasingly follow volume. Empty rooms, late starts and underutilized blocks will become harder to defend. If surgeons want premium coverage, we need disciplined schedules.
- Case mix. Total joints, spine, trauma add-ons and higher-acuity orthopedic cases require a more sophisticated anesthesia partner than low-acuity cases. Regional block expertise and comfort with outpatient orthopedic pathways will matter.
- Subsidy accountability. If the anesthesia group asks for financial support, the ASC should ask for measurable service commitments in return.
- Payer pressure. If facility reimbursement tightens while anesthesia costs rise, the ASC margin gets squeezed. That means we have to be selective about case mix, implants, contracts, room utilization and staffing models.
My expectation is that the successful ASC anesthesia model will not be purely transactional. It will need to be a true strategic partnership. We need anesthesia coverage that protects patient safety, supports surgeon growth, gives us flexibility for add-ons and still makes financial sense for the center.
Tricia Wollam. Administrator of Alliance Surgery Center (Traverse City, Mich.): Over the next five years, anesthesia coverage will become one of the most important operational and financial challenges facing ASCs. I think we will see greater reliance on CRNAs, subsidies will become the norm, and we will have to become much more flexible and creative in our staffing models. On a positive note, within the next five years more anesthesia providers will be looking for better work/life balance, and more providers will gravitate to the ASC because they can provide efficient rooms, predictable schedules, no call; all while having a positive culture.
Kevin Youmans. Administrator of Casper (Wyo.) Surgical Center: Our center has maintained an anesthesiologist-only model for many years and currently does not require an anesthesia coverage subsidy. While we do provide a Medical Director stipend for administrative responsibilities, our anesthesia providers bill independently for their professional services.
At this point, I do not anticipate significant changes to our anesthesia coverage model over the next five years. We have benefited from a long-standing, stable relationship with our anesthesia group and continue to view them as important partners in the success of the center.
While many discussions focus on anesthesiologist versus CRNA models or the growing use of coverage stipends, I believe alignment and long-term partnership between ASCs and anesthesia providers will be just as important as the coverage model itself. Organizations that maintain strong relationships with their anesthesia providers and create an environment where both parties can succeed will be in the best position to maintain stable coverage.