The corporatization of anesthesiology — driven by private equity activity, hospital acquisitions and national practice roll-ups — is transforming how care is delivered, raising concerns about costs, access and physician autonomy.
Here are five key dynamics shaping the trend:
1. Rapid consolidation of anesthesia groups
Private equity firms and large physician management companies continue to acquire anesthesia groups, creating national platforms that control large shares of local markets. In some states, a single corporate entity manages anesthesia services for dozens of hospitals and surgery centers.
“Consolidation is the dominant trend in the ASC space today, largely driven by rising labor costs, supply chain disruptions and mounting pressure on reimbursement,” Megan Friedman, DO, anesthesiologist and director of Pacific Coast Anesthesia Consultants, told Becker’s in June.
2. Financial pressures fueling corporate ownership
Rising surgical demand and reimbursement pressure are making anesthesia practices attractive targets during ASC consolidation, while outsourcing can ease near-term administrative burden yet contribute to longer-term instability when contracts or staffing circumstances change.
3. Provider autonomy under strain
Anesthesiologists and certified registered nurse anesthetists working under corporate ownership often report reduced autonomy. National groups may impose staffing minimums, restrict scheduling flexibility and prioritize financial performance over clinical decision-making, physician leaders told Becker’s in June.
“The consolidators just keep getting bigger; whether it comes to platforms or health systems, it’s definitely becoming more corporate,” Scott Mayer, CEO of Ambulatory Anesthesia Care, told Becker’s. “That’s forced a lot of [providers] — especially on the anesthesia side — to be their own independent contractors.”.
4. Rising scrutiny from regulators
A study published in April 2022 in JAMA found that anesthesia prices increased an average of 26% after private equity acquisitions, with nearly one-third of anesthesiologists absorbed through such buyouts.
More recently, the Federal Trade Commission sued U.S. Anesthesia Partners and its private equity backer Welsh, Carson, Anderson & Stowe, alleging an anticompetitive scheme in Texas that inflated costs. The case ended in a January settlement requiring WCAS to limit its involvement with USAP and notify the agency of future acquisitions.
5. Threats to rural access and community hospitals
CRNAs provide more than 80% of anesthesia in rural counties, making them critical to surgical access in community hospitals. As consolidation and workforce shortages intersect, smaller facilities face heightened risk of canceled procedures or even permanent loss of surgical services.
“Rural hospitals often depend on just one or two anesthesia providers to keep their surgical services operational,” Allyn Miller, CRNA, regional director of anesthesia operations at Franklin, Tenn.-based Community Health Systems, told Becker’s in June. “If those providers cut hours or leave, it can result in temporary or permanent loss of surgical capabilities, forcing patients to travel long distances for care or forgo needed procedures altogether.”