Managing the Cost of Anesthesia Stipends

As we have discussed previously, we are witnessing a sharp increase in hospitals having to pay large amounts of financial support to their anesthesiologists. These payments typically come about through a series of events such as the following:

• Increasing market rates for anesthesiologist and certified registered nurse anesthetist (CRNA) compensation outstrip the anesthesia group’s ability to generate revenue.
• Providers leave the group for greener pastures (which they can do very easily in their specialty), and replacements can’t be recruited at a price the group can afford.
• The group quickly becomes unstable, and soon the hospital is faced with the prospect of inadequate anesthesia coverage.

We have also offered some pointers to hospitals on how to deal with the situation when it arises.

However, these stipends will likely only grow in the future, and maintaining an adequately staffed anesthesia department will remain a chronic challenge. In this article, we dig deeper into the underlying reasons why this is the case and offer advice on how to manage the situation on a continual, rather than an episodic, basis. Recent experience has demonstrated that ongoing, proactive management is necessary because negotiating an anesthesia stipend is often not a “one and done” affair. Many of our clients have established financial support arrangements only to find that within a year or so, the situation has changed and they must return to the negotiating table to address yet another increase in financial support.

Rising Anesthesia Compensation Levels

Compensation levels for anesthesiologists and CRNAs are rising rapidly, as any provider in the field will tell you. To some extent this is evidenced by survey data, but these surveys always lag behind the market by one to two years and are still somewhat skewed by the effects of the pandemic. A more vivid illustration of what is currently happening can be seen in the rapidly increasing number of posted job offers.

As with any good or service, the price for anesthesia providers is a function of supply and demand, and there are major forces at play with both.

Beginning with supply, there simply are not enough anesthesia providers in the market. (A quick Google search will uncover numerous whitepapers and studies making this assertion.) As a group, anesthesiologists are older than physicians in almost every other specialty, and by all indications they are retiring faster than new anesthesiologists are joining the workforce. CRNA programs have alleviated the shortage of anesthesiologists somewhat and are now producing graduates at a faster pace than anesthesia residencies. While this helps, it also alters the mix of anesthesia providers in the market, which has significant staffing implications for hospitals.

_{Edited by: Matt Maslin
Designed by: Mary Anne Akhouzine}