Eight states have no anesthesia residency program, which means ASCs operating in those markets have no local pipeline and no structural fix on the horizon.
Here are 10 more things to know about the geographical discrepancies in the anesthesia provider shortage:
1. According to data from the Bureau of Labor Statistics, the states with the fewest anesthesiologists per capita include Nevada, New Mexico, Pennsylvania and Louisiana. Arizona, California, Vermont and Massachusetts have the lowest number of CRNAs. Some states have employment estimates not released by the BLS. Other reports have Idaho ranking at 5 anesthesiologists per 100,000 people; South Dakota at 9; Mississippi at 10; North Carolina at 11.
2. More than half of states are projected to fall below 90% adequacy, and at least a dozen states are expected to meet less than 70% of projected demand, according to projections from the Department of Health and Human Services’ Health Resources and Services Administration.
3. Southern and Mountain West states, including Mississippi, Alabama, Georgia, South Carolina and Idaho, face some of the steepest gaps, with projected adequacy rates below 60%. Massachusetts, New York and Vermont are expected to exceed projected demand, while California, Nebraska and Wisconsin are forecast to hover near equilibrium.
4. Eight states do not have anesthesia residency programs: Alaska, Delaware, Hawaii, Idaho, Montana, North Dakota, South Dakota and Wyoming. Several of these overlap with the lowest-per-capita states, meaning they face the worst current shortage and have no infrastructure to grow their own supply.
5. CRNAs deliver more than 80% of anesthesia services in rural counties, administering over 50 million anesthetics each year, according to the American Association of Nurse Anesthesiology. Yet staffing gaps are ballooning, with facilities reporting anesthesia shortages rose from 35% in 2020 to 78% by late 2022.
6. The predominantly CRNA model was used in only 10% of large urban hospitals but in 61% of rural ASCs, according to a 2024 study from Science Direct.
7. In rural areas, 75% of CRNAs report practicing independently. In states without residency programs and with thin per-capita physician counts, CRNAs are often the only coverage available, and their pipeline is also strained.
8. By 2033, the U.S. is projected to face a shortage of about 12,500 CRNAs, nearly 22% of the current workforce. Demand remains high, with the Bureau of Labor Statistics projecting 38% growth in the field by 2032.
9. The anticipated shortage is compounded by a tightening pipeline: as of 2025, new CRNA graduates must earn doctoral degrees, and CRNA schools average just a 24% acceptance rate.
10. States like Wyoming, North Dakota, and Montana have more rural coverage areas. Hospitals and surgery centers in these regions must offer top-tier compensation to attract and retain specialists. According to data from BagMask, those markets are advertising among the highest anesthesiologist salaries in the country as a direct result.