EHC’s QA Series Question 2

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June 11, 2020

What type of anesthesiologist and CRNA movement are you seeing around the country?

Due to the COVID-19 pandemic, the resulting economic uncertainty, and further consolidation of Anesthesia Practice Management groups, we are hearing a renewed interest of both providers and hospitals seeking to change the “Anesthesia Playing Field.” Many Anesthesiologists and CRNAs have had their pre-COVID jobs disrupted and are seeking a change in practice setting, location (urban vs. rural), or group affiliation. Like most of us, many anesthesiologists and CRNAs, both new graduates and seasoned clinicians, have experienced a reduction in compensation and are uncertain about the return of surgical volume and resultant revenue increase. Even hourly rates for locum CRNAs have come down in certain geographies.

Before the pandemic started, and picking up steam in the past few weeks, we have heard of more hospitals deciding to employ their anesthesia service, resulting in unrest and movement within groups. Some facilities are providing a lifeline for smaller groups unable to navigate the new world of decreased cash flow, subsidy reduction, PPP and HHS loans.  Other systems have grown tired of outsourcing anesthesia services to large AMPs and the recent acquisitions of some, and bankruptcy discussions of others, has the potential of further muddying the waters in many areas. My intent is to not paint all with the same brush, however I will share this recent quote from an EHC client and the CEO of a large facility about their long standing anesthesia service provider “We are still at a cost plus…yet they continue to apply corporate methodology to us and disregard the needs on the ground.  Their scale, combined with non-competes has put a choke hold on any client creating de-facto monopolies in certain markets that have resulted in increasing costs to hospitals, and ultimately consumers…”

We are waiting to see the final results COVID-19 will have on movement of providers and the overall anesthesia landscape. Perhaps a new normal in the Anesthesia Provider Group will emerge. Will Hospital relationships be forged in the aftermath of the pandemic?

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Response provided by: Howard Greenfield, MD