Ambulatory surgery centers are facing mounting pressure across the anesthesia landscape. Today, 78% of surgery centers report anesthesia staffing shortages, labor costs have increased 15–25% since 2020, and many facilities are seeing 2–3x increases in locum tenens utilization, significantly driving up subsidies and operational strain.
Against this backdrop, ASC leaders are being forced to rethink traditional anesthesia models and seek partners who can deliver not just coverage, but flexibility, transparency, and performance.
Limestone Surgery Center, part of the SCA Health network, faced many of these same challenges. The center was experiencing rising anesthesia costs with limited transparency and operating within a staffing model that did not fully align with the complexity of its environment. As a larger, multi-room ASC with both operating rooms and high-volume endoscopy suites, Limestone required a more tailored approach to balance efficiency, cost, and clinical quality.
NorthStar Anesthesia partnered with Limestone in 2023 to redesign the care model around how the center actually operates. By introducing a more flexible staffing structure, including independent coverage for high-efficiency endoscopy rooms and optimized anesthesiologist deployment across operating rooms, the team has been able to better align resources with demand and improve overall efficiency.
A critical component of this transformation was the establishment of strong, on-site clinical leadership. NorthStar built a new care team from the ground up, including a dedicated chief CRNA and anesthesiologist medical director, both focused on accountability, collaboration, and building a high-performing culture. This leadership model helped create trust, improve communication, and ensure alignment with the center’s operational goals.
“Our goal is always to operate as a true partner,” said Cindy Myers, Vice President of ASC Operations at NorthStar Anesthesia. “At Limestone, that meant being creative with the care model, aligning to their operational goals, and building a team that could deliver both clinically and operationally.”
Through close collaboration, Limestone implemented more disciplined scheduling practices and optimized operating room utilization. Avoiding unnecessary room openings and improving block efficiency enabled the center to increase throughput while maintaining high-quality care. The center outperformed expectations, demonstrating measurable improvements in both operational efficiency and financial performance.
“NorthStar took the time to understand how our center operates and worked with us to build a model that supports both our clinical and business goals,” said Kelly Wright, CEO of Limestone Surgery Center. “That level of partnership has made a meaningful difference for our team and our patients.”
Limestone’s experience reflects a broader shift in the ASC market. Sustainable performance today requires more than staffing coverage. It requires a partner who can combine national recruiting capabilities with strong local leadership, flexible care models, and a commitment to shared success.
In a market defined by rising demand and constrained supply, the ability to build efficient, stable, and collaborative anesthesia programs is becoming a defining factor for ASC performance and growth.
NorthStar’s work with Limestone demonstrates what is possible when anesthesia is approached not as a service, but as a strategic partnership.
