Texas Spotlight: When Anesthesia Becomes Your Greatest Operational Risk

How Texas Hospitals Are Building Stability in an Unstable Market

Across Texas, hospitals are confronting one of the greatest operational threats to surgical services in decades.

Persistent clinician shortages, particularly among physician anesthesiologists, rising labor costs and mounting financial pressure have transformed anesthesia from a clinical service into a strategic business risk. Operating rooms sit idle because they cannot be staffed. Hospitals become increasingly dependent on costly locum tenens providers. Surgical growth slows while anesthesia subsidies continue to rise.

For many hospital leaders, the question has shifted from whether they can find anesthesia coverage to whether they can find a partner capable of adapting as their organization evolves.

The challenge is especially acute in Texas, where large anesthesia groups have historically dominated many metropolitan markets. When staffing shortages occur, resources are often pulled back to flagship hospitals, leaving surrounding community hospitals with inconsistent coverage, growing vacancies and mounting operational strain. At the very moment hospitals are being asked to improve margins and expand surgical services, many find themselves constrained by an anesthesia model that cannot evolve with their needs.

NorthStar has built a different model: one designed to help hospitals adapt.

Whether the need is rebuilding an unstable workforce, improving financial efficiency or supporting rapid growth, the goal remains the same: align anesthesia services with the hospital’s broader business objectives.

Building Trust Through Uncertainty

A hospital in Fort Worth experienced firsthand how quickly those objectives can change.

As the COVID-19 pandemic collided with a period of organizational growth, the hospital faced rising labor costs, reimbursement changes and increasing financial pressure. Rather than treating those conversations as contract negotiations, NorthStar worked alongside hospital leadership to evaluate data, model different scenarios and make difficult decisions together.

As the CEO reflected, “There wasn’t a playbook for what we were facing. Every month brought a new challenge. What I appreciated most was that NorthStar never came to us with surprises—they came with data, options and a willingness to solve the problem together.”

That transparency built trust and established the foundation for a long-term partnership.

From Stabilization to Growth

The same approach has played out across the Dallas-Fort Worth market.

At another hospital in the area, NorthStar assumed responsibility for an anesthesia program after the previous provider exited. Only about one-quarter of the required CRNA workforce remained, placing the hospital’s surgical operations at significant risk. Through sustained investment in clinician recruitment, academic partnerships and local leadership, NorthStar rebuilt the practice into a fully staffed, stable program. Today, the hospital has shifted from crisis staffing to supporting future surgical growth.

As one hospital leader described it, “What impressed us was that they built a team that stayed. Today, we have confidence that our anesthesia program can support wherever our hospital goes next.”

That long-term approach is reflected across NorthStar’s Texas operations, where the organization reports a 92%+ five-year clinician retention rate, demonstrating that workforce stability extends well beyond initial recruitment.

Texas Health Mansfield illustrates what happens when that stability becomes a platform for growth.

NorthStar began its partnership with Texas Health Mansfield during the COVID-19 pandemic and fully staffed the program before the transition date. The team grew from one physician and three CRNAs to one physician and nine CRNAs, supporting five points of service including labor and delivery, endoscopy, the cath lab and radiology. As surgical demand increased, NorthStar added an additional point of service in just one week while helping establish a more collaborative physician-CRNA practice culture.

The results extend beyond staffing. Since NorthStar assumed the program, surgical volume has increased by nearly 20% year over year, the hospital has expanded and added service lines and is preparing to add a surgery center and two additional operating rooms. For CEO Eulane Lashley, the anesthesia program has become an engine for growth:

“What gives me confidence is knowing anesthesia isn’t something we have to worry about anymore. As we’ve added surgeons, expanded services and planned for two new operating rooms and a surgery center, I’ve never questioned whether NorthStar would be ready. They’ve grown right alongside us.”

Agility in Action

Growth is only one side of today’s challenge.

Hospitals must also respond when volumes soften, financial pressures increase or service needs change.

One South Texas hospital experienced both realities within a matter of months. To improve financial performance, NorthStar helped reduce anesthesia coverage by four points of service. Just weeks later, after new surgical business was secured, the organization expanded by five points of service within approximately 90 days, allowing the hospital to capture growth without disrupting operations.

As one executive explained, “Our priorities changed almost overnight. We needed to be more efficient, and then before long we were growing again. NorthStar adjusted right along with us.”

Today’s hospital leaders are looking for more than anesthesia coverage. They need a partner that can help them navigate change, whether that means rebuilding an unstable workforce, improving financial efficiency or supporting the next phase of growth. Across Texas, NorthStar has demonstrated that the strongest anesthesia programs are built not just to meet today’s demands, but to adapt to tomorrow’s.