We find you the numbers you want.
Independent anesthesia consulting for hospital leadershipOn the hospital’s side of the table.
The anesthesia group across the table negotiates for a living. We give your leadership team its own model, its own benchmarks and its own advisor.
7:30 a.m.
The first case of the day.
Every room, every minute.
Six rooms on the board. One sits empty.
An idle room still costs money.
About $58 for every minute it sits empty.
Four parties at the table.
One of them is on yours.
The subsidy keeps rising. The revenue behind it doesn’t.
- $185,000Average annual subsidy per anesthetizing location, contracts signed in the last three years.1Up 30% from $132,000 in the three years before.
- $66 / minAverage hospital OR revenue per minute — about $4,000 an hour.2Against an average cost of $58 per minute.
- +54%Rise in the cost of one OR minute, FY 2014 to FY 2022.2Idle rooms get more expensive every year.
- +28%Rise in average CRNA pay, 2019 to 2024.3$181,040 to $231,700 — a cost passed through to you.
- −5%Change in Medicare’s anesthesia payment per unit, 2019 to 2023.4$22.27 to $21.12. Group revenue falls; subsidy requests rise.
They negotiate for a living. You negotiate every few years.
Subsidy requests arrive with a deadline, a warning about coverage gaps and a spreadsheet you didn’t build.
Fifth Party rebuilds the math from your own data, so the next decision is made on your numbers, not theirs.
Five services. Each answers one question your board will ask.
- 01
Coverage and subsidy review
“Are we paying the right amount for what we get?”
- 02
Care-team model design
“Is our anesthesiologist, CRNA and AA mix right for our case mix and OR hours?”
- 03
Group RFP and transition
“Should we change groups, and how do we do it without a coverage gap?”
- 04
Contract negotiation support
“What should we accept, and where should we hold firm?”
- 05
Performance monitoring
“Are we getting what the contract promised, quarter by quarter?”
Four parties already have a seat. We are the fifth — and we sit on your side.
No fees from anesthesia groups, staffing firms or vendors. Our only client is hospital administration.
Clinicians and administrators, working for administration.
Fifth Party employs a group of physicians, CRNAs, experienced consultants and people with hospital administrative experience. We know how an anesthesia department runs from the inside, and how its costs look from the C-suite.
- Physicians (MDs)
- Clinical judgment on coverage, acuity and care-team design.
- CRNAs
- How rooms, schedules and staffing actually run day to day.
- Experienced consultants
- Benchmarking, financial modeling and negotiation.
- Administrators
- Budgets, boards and the contracts that tie them together.
Decision first. Evidence behind it.
- Step 1
Listen
A 30-minute call with your leadership team.
- Step 2
Measure
We build the model from your own OR, billing and contract data.
- Step 3
Decide
Options, trade-offs and one clear recommendation.
- Step 4
Deliver
Negotiation, RFP or transition support through signature.
Your next anesthesia contract starts before the group’s letter arrives.
Confidential. No obligation. For hospital and health-system leaders.
Sources
- 1Enhance Healthcare Consulting, “Anesthesia Subsidies: Putting It All on the Table,” first published September 2022, updated July 2025. Database of 120+ hospitals.
- 2Ashrafi, Maggard-Gibbons, Childers. “Costs, Charges, and Revenue of Hospital Operating Rooms in California.” JAMA Surgery, July 2026. 278 California hospitals, FY 2022.
- 3U.S. Bureau of Labor Statistics, as reported by Becker’s ASC Review, December 2025.
- 4VMG Health, “Understanding & Solving the New Reality for Anesthesia Services,” 2023.