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ASCA Survey Shows Improvement in Access to Anesthesia Services

Answers varied according to facility size

BY ALEX TAIRA | NOVEMBER 15, 2024

ASCA’s October 2024 60-Second Survey asked questions regarding facility operations with regards to anesthesiology services. The survey received 320 responses from surgery centers in 46 states.

Survey Results

Overall, 70 percent (225/320) of survey respondents reported having adequate access to anesthesia providers, up from 64 percent in 2023 and 56 percent in 2022.

However, reported access to anesthesia services varied according to facility size. Only 61 percent (59/97) of large surgery centers—facilities with five or more operating/procedure rooms—stated having adequate access to anesthesia services, compared to 81 percent (83/103) of small ASCs—facilities with one or two operating/procedure rooms.

Low supply of anesthesia providers was the most common reason for struggling to maintain services, although the number of facilities that reported low supply of providers decreased slightly from 2023: 90 percent in 2023 to 81 percent in 2024. Facilities reporting high expense as a reason for struggling to maintain services increased to 67 percent, up from 61 percent in 2023. Other reasons for struggling to access anesthesia services included competition between facilities and low contracted rates from payers. A majority of facilities, 75 percent (70/94), that had difficulty maintaining anesthesia providers said that it impacted their surgery center’s procedure volume, down slightly from 80 percent (80/100) in 2023.

Contracted Versus In-House Anesthesia Services

A large number of surgery centers, 82 percent (262/320), reported using a contracted anesthesia service in 2024, as opposed to employing anesthesia providers in-house, down from 86 percent in 2023. Of note, when filtering for facility demographic features two subgroups showed an increase in in-house employment of anesthesia providers compared to 2023. For small facilities, 18 percent (18/103) reported employing anesthesia providers in-house in 2024, up from 10 percent (8/82) in 2023. Similarly, 19 percent (26/137) of solely physician-owned surgery centers reported employing anesthesia providers in-house in 2024, up from 11 percent (13/119) in 2023.

Financial Assistance

Only 30 percent (92/311) of surgery centers surveyed said they offer financial assistance as incentives for contracts with anesthesia providers/groups. This is less than the 41 percent in the 2023 survey, although that survey limited responses to the 100 facilities that also said they had struggled to maintain anesthesia providers. Facilities that utilize ownership partnerships with a hospital or corporate group were more likely to offer financial assistance—40 percent offer assistance—compared to solely physician owned surgery centers—19 percent offer assistance. Similarly, large facilities were more likely to offer financial assistance agreements (38 percent) than small facilities (21 percent).

Of those facilities that reported offering financial assistance in 2024, stipend contracts were the most common assistance agreement offered at 53 percent, followed by collections guarantees (30 percent), flat subsidies (21 percent) and volume minimums (15 percent). Facilities also mentioned using variable subsidies and other incentives like discretionary bonuses to maintain anesthesia providers.

ASCA introduced the 60-Second Survey, a quarterly survey series, in spring 2021. As the name suggests, each survey takes 60 seconds or less to complete and asks fewer than 10 questions on a current topic. e. The topic changes survey to survey, but each aims to take the pulse of the ASC community and help ASCA better serve its members and the ASC community at large.

Write Alex Taira with questions about this survey or to propose topics for future surveys.