The anesthesia industry is facing a mounting provider shortage, with demand for anesthesiologists far outstripping supply.
Alongside these shortages, there are several other looming challenges facing anesthesia providers and those looking for coverage.
Here are four more key challenges facing the anesthesia industry today:
Alignment
For Jack Dillon, CEO of Anesthesia Practice Consultants, one of the biggest issues is aligning physicians and certified registered nurse anesthetists with the needs of the facilities.
During a June 22 panel at the 21st Annual Spine, Orthopedic & Pain Management-Driven ASC + The Future of Spine Conference in Chicago, Mr. Dillon said he's facing the challenge of 135 physicians and 95 CRNAs and anesthesiology assistants "trying to crawl over each other to work in the ASCs and get out of the hospital."
While alignment is a "big project," Mr. Dillon added, his team has plenty of ASCs with regional blocks at certain times.
"Finding those unicorn anesthesiologists or staff that can support that sort of thing is definitely both an art and a science and takes a lot of partnership between your centers because when you can get that humming, it works beautifully," he said. "And from our perspective, the value proposition to that center goes up quite exponentially. You're able to do and support in the way that they want to run and operate."
Private equity
Anesthesia is also facing mounting challenges of private equity influence.
Around 20% anesthesia practices that made up private equity physician practice buyouts, according to a study published in JAMA Network in February 2020. Another JAMA study published in 2022 found that prices increased, on average, 26% when anesthesia companies backed by private-equity investors took over at a hospital outpatient or surgery center compared to independent practices.
"If you Google search right now on private equity and anesthesia, you won't find a single positive story going on in the market," Mr. Dillon said on the panel. "It's all pretty devastating to communities, and that's a lot of the work that our association works on with other independent groups — you can stay independent, you can partner with surgical centers, you can make your practice work and function, and you don't need outside dollars to do it."
Reimbursement declines
Anesthesia is also facing declines in coverage from CMS and other payers. CMS anesthesia reimbursements declined 8.2% from 2019 to 2024 — from $22.27 per unit to $20.44, VMG Health said in a May 22 blog post.
"[The decline] is devastating to any anesthesia group, department or otherwise," Mr. Dillon added. "The margin is just not there. We have some financial support from some of our ASCs, but we've worked with our other ASCs to align in a way to ensure that finances line up with the work that you're doing."
No Surprises Act
For many anesthesia providers, the No Surprises Act and its independent dispute resolution process have created further obstacles to secure reimbursements.
While Mr. Dillon said that this issue hasn't hit his group, he's heard "pretty horrific stories of claims just being delayed and there being no reimbursement on those claims," from other groups, particularly in the South.
"It becomes a community crisis because how do you expect an anesthesia group to support itself if they're not getting paid anything with all these claims in arbitration?" he said. "I don't know what the resolution was on any of those, and hopefully it gets figured out sooner rather than later."