Service
Hospital-employed anesthesia: insourcing support
“Should we take anesthesia staffing in-house?”
Some hospitals decide the best anesthesia group is their own. Employing physician anesthesiologists, CRNAs and certified anesthesiologist assistants gives the hospital direct control of coverage, recruiting and cost, and removes the group’s management fee and margin from the price.
It also moves real work and risk onto the hospital: recruiting in a tight market, clinical leadership, scheduling and call, malpractice, credentialing, payer enrollment and anesthesia-specific billing. We model employed, contracted and hybrid options side by side, and plan the transition if the numbers support it.
What we look at
- What the current subsidy buys, and what the same coverage would cost employed
- Recruiting conditions by role: physician anesthesiologists, CRNAs and, where state law allows, CAAs
- Compensation, benefits, call pay and malpractice for an employed team
- What the hospital would collect: payer mix, enrollment and anesthesia-specific billing
- Clinical leadership, quality review and scheduling
- Notice, non-solicitation and restrictive covenants in the current agreement, for review with counsel
- Hybrid options, such as employed CRNAs and CAAs with contracted physician medical direction
What you get
- A side-by-side cost model: contracted, employed and hybrid
- The risks of each option and how to manage them
- A recommendation, and if it is to insource, a phased transition plan
- Recruiting, billing and leadership plans for the first year
What we need from you
- The current anesthesia agreement and its termination provisions
- Coverage requirements by location and hour
- Payer mix for anesthesia services
- Human resources and finance partners for compensation and benefits modeling
- Counsel available for employment and contract review
Right for you if
- Your group is leaving, dissolving or selling
- The subsidy has grown enough that employment deserves a serious look
- You want direct control of coverage and recruiting
Probably not a fit if
- You cannot add clinical leadership, recruiting and billing oversight in the next year
Questions
- Is employing anesthesia staff always cheaper?
- No. It removes the group’s overhead and margin, but the hospital takes on recruiting, leadership, billing and the cost of vacancies. For some hospitals the numbers work; for others a better contract is the right answer.
- Can we employ part of the team?
- Yes. Hybrid models are common, for example employed CRNAs and CAAs with physician medical direction under contract. We model the options that fit your state rules and recruiting market.
- Do you recruit or staff for us?
- No. We do not staff operating rooms or place clinicians, so our advice is never tied to filling positions ourselves.