The anesthesia financial picture
The same operational facts — coverage, case mix, support ratios — in dollars. This is the CFO view: what the anesthesia subsidy buys, where margin is made and lost, and the compliance + retention dollars at stake. Illustrative, synthetic numbers.
Anesthesia subsidy / yr
$3.3M
What the hospital pays to cover anesthesia beyond collections. FMV band $2.3M–$3.9M.
Cost / location-day
$7,452
Fully-loaded cost to staff one anesthetizing location for a day across 2,903 location-days.
TEFRA $ at risk
$479K
Medical-direction compliance exposure. Currently 94.3% compliant.
Throughput ROI
+$1.2M
A 5.0% prime-time / turnover gain converted to contribution margin at $43.1/OR-min.
Subsidy vs. fair-market-value band
This site’s subsidy sits inside the FMV range — the defensible-payment story for a contract negotiation.
FMV low $2.3MFMV high $3.9M
Contribution margin & subsidy by service line
Obstetric labor coverage runs thin/negative margin — a 24/7 obligation that justifies the subsidy. Cardiac is margin-rich and pays back its midlevel stipend.
| Service line | Cases | Cost/case | Margin/case | Total margin | Subsidy share |
|---|
| Main OR | 2,646 | $1,662 | $+1,854 | $4.9M | $728K |
| Cardiac | 348 | $3,883 | $+3,970 | $1.4M | $397K |
| Obstetric (L&D) | 709 | $907 | $+157 | $111K | $1.4M |
| Non-OR Anesthesia | 632 | $785 | $+744 | $470K | $795K |
Cardiac midlevel stipend ROI
A $125K/yr stipend pool across the cardiac midlevels. At the cardiac contribution margin, it breaks even at 31 cardiac cases — well under the 348 delivered. Cost per cardiac case covered: $359.
Workforce / retention economics
Replacing one anesthesiologist costs $888K; a CRNA/AA $105K. Workload inequity (Gini 0.12) carries ~$224K of avoidable turnover cost per inequitably-loaded FTE.
Synthetic data · illustrative · magnitudes within published anesthesia-economics benchmark ranges