As ASCs face ongoing workforce constraints, reimbursement pressure and rising expectations around access and efficiency, anesthesia coverage has emerged as a defining operational priority for 2026.
ASC leaders across the country joined Becker’s to share the anesthesia coverage elements they consider non-negotiable, and why those priorities have become firm lines in the sand for protecting patient care, physician confidence and ASC performance.
Question: What’s your non-negotiable in your 2026 anesthesia coverage strategy — and what made it a hard line?
Editor’s note: Responses have been lightly edited for clarity and length.
John Beauchamp. Senior Director of Administration, Revenue Cycle and Data Analytics at GI Associates (Milwaukee): From a gastroenterology ASC standpoint, our non-negotiable for 2026 is reliable [monitored] anesthesia coverage that fully supports GI block schedules set months in advance.
Most of our GI anesthesia coverage is provided by independent-contract anesthesiologists and CRNAs, many of whom balance this work alongside other full- and part-time clinical roles. That structure is not unusual in GI anesthesia, but without advance, block-aligned commitments, independent-contractor models introduce real and recurring coverage risk for ASCs.
When MAC anesthesia is unavailable, cases often shift to IV sedation. While clinically appropriate in select situations, IV sedation is operationally less efficient, increases procedure variability and limits room throughput. The downstream effects are immediate and measurable: longer turnover times, underutilized rooms, cancelled or deferred cases, frustrated physicians, delayed patient care and a suboptimal patient experience.
As reimbursement pressure and workforce constraints intensify, anesthesia strategies must prioritize predictability and block alignment. Anesthesia groups built largely on independent contractors aren’t unusual in GI, but without advance commitments aligned to GI block schedules, meaningful and potentially recurring coverage risk exists for ASCs.
Peter Bravos, MD. Chief Medical Officer of Sutter Surgery Center Division (Sacramento, Calif.): My non-negotiable 2026 anesthesia coverage strategy is guaranteed, dependable coverage that protects patient safety and access to care while maintaining a sustainable cost structure.
This has become a hard line for us in that access has emerged as our primary rate-limiting factor to maximizing ASC performance. Variability in anesthesia coverage erodes utilization, surgeon confidence and the patient experience, while creating workforce risks that far exceed any short-term cost benefit. As a result, anesthesia coverage reliability must be treated as a core “non-negotiable” operating requirement rather than a discretionary cost lever.
Trina Cole. Administrator of St. Luke’s Surgicenter Lee’s Summit (Mo.): Deep knowledge of ASC processes and workflow is my non-negotiable in our 2026 anesthesia coverage strategy.
Patrick Magallanes. President and CEO of Steindler Orthopedics (North Liberty, Iowa:): For 2026, flexibility and innovation are welcome, but coverage reliability, accountability and alignment with our operating model are non-negotiable. Any solution must support full OR utilization, defined coverage expectations and a structure where we control our access, not one where access is contingent on external leverage.
Raghu Reddy. Chief Administrative Officer of MiOrtho Surgery Center (Southfield, Mich.): As we align on our 2026 anesthesia coverage model, I want to clarify a few non-negotiables for our ASC. Primarily, adequate, high-quality staffing coverage with consistent providers. It’s essential that our anesthesia team consists primarily of regular providers who know our surgeons, workflows and standards. This continuity is critical to reducing quality issues and avoiding unnecessary day-to-day variability.
Additionally, flexibility to cover trauma add-on cases. Our practice includes trauma add-ons, and we need a coverage approach that recognizes this reality and supports timely, optimal accommodation of these cases.
It is a hard line based on our experiences and what works well for us for patient care each day.
At the same time, we recognize our responsibility on the ASC side. We must maximize block time utilization through disciplined scheduling and efficient use of OR time. The goal is to avoid subsidy requirements wherever possible and create a sustainable, win-win partnership for both organizations.
Chuck Schwab, RN. Executive Director for ASC Ventures of Illinois Bone and Joint Institute (Des Plaines): For us, high-quality, best-practice clinical standards and positive patient outcomes are non-negotiable for 2026. This has become expected, regardless of potential stipends paid to anesthesia groups. We demand clinically sound and safe protocols and we have partnered with our anesthesia providers to ensure this.
The hard line began a few years ago when we explored other anesthesia models to help reduce our costs and stipends. We kept quality and patient safety as top priorities instead of potentially saving dollars with alternative anesthesia models we were not comfortable with.
Charles “Chuck” Tabbert, CRNA. Anesthesia Department Chief at Mercy Health – Defiance (Ohio) Hospital: Flexibility is our non-negotiable. Flexibility with our facility partner to collaboratively adjust points of service. Flexibility in staffing to design roles that work for real people. And flexibility from providers, starting with clinical versatility and a team-first mindset that covers for each other. Without it: inefficiencies build, clinician morale erodes, culture deteriorates and downstream costs balloon.