I’ve been working in and around the surgical and anesthesia space for more than a decade, first in hospital strategy and operations, now as the founder of a firm that connects CRNAs with top-tier locum tenens opportunities. And I can say this without hesitation:
CRNAs are no longer just supporting the anesthesia model, the market is being redefined.
CRNA Trends. The Clinical Shift is Real, and Measurable.
Let’s start with the numbers. In 2013, CRNAs delivered around 35 million anesthetics. Today? That number is closer to 50 million, and it’s projected to surpass 55 million by 2028.¹,² At the same time, anesthesiologist-delivered anesthetics have dropped from ~30 million in 2013 to around 21–25 million today—a trend expected to continue as more physicians retire or shift to supervisory roles.²
Overlay that with national surgical demand, which rebounded post-pandemic to ~50 million cases in 2023, and is expected to reach ~60 million by 2028.³ It’s easy to see why CRNAs are more essential than ever.
Wages Reflect That Value
Over the last five years, CRNA compensation has risen more than 20%, outpacing other APPs. The average salary jumped from $174,790 in 2018 to over $221,000 in 2023,⁴ and current projections place it at $245,000+ by 2027.⁵ Those numbers are even stronger for CRNAs working contract or 1099 roles, many of whom are earning at or above market rate due to the flexibility and speed locum coverage provides hospitals.
Why So Many CRNAs Are Choosing the 1099 Path
At Royal Surgical Associates, we speak to providers every week who are weighing a move away from the W-2 model. For a growing number of CRNAs, 1099 work just makes more sense. Here’s why:
- Higher Earning Potential
As an independent contractor, you can negotiate your rates, avoid employer overhead, and often earn more, especially in rural or high-demand settings. In a tight labor market, scarce skills are leverage. - Real Tax Advantages
1099 CRNAs can deduct business expenses: travel, housing, CME, scrubs, licensure fees, and more. With the right planning, your taxable income becomes far more manageable—and you keep more of what you earn. - Lifestyle Flexibility
You decide when and where to work. Want winters off? Prefer 13-week assignments? Don’t want to take call? That’s all on the table. The schedule works around your life, not the other way around. I’m not saying you’ll get everything you want, but this is definitely a shift back to the provider as opposed to the long-time position of strength from the employer. - Solo 401(k) & Retirement Power
Here’s a hidden gem: As a 1099 CRNA, you can contribute to a solo 401(k) as both the employee and the employer. In 2024, that means up to $69,000 annually, or $76,500 if you’re over 50.⁶ That’s a game-changer for long-term wealth building.
Why the Market is Leaning on CRNAs
Two big trends are accelerating this shift:
- Physician Shortages: The anesthesiology field is on track for a shortfall of over 12,500 physicians by 2033.⁷ The supply just isn’t keeping up with retirements or demand.
- Expanded Scope of Practice: More than 20 states now allow CRNAs to practice independently.⁸ In many hospital and ASC settings, CRNAs are leading cases without direct physician supervision, and excelling at it.
Add the growth of ambulatory surgery centers (expected to handle 60% of all surgeries by 2025), and CRNAs aren’t just in demand, they’re indispensable.
If you’re a CRNA who’s been thinking about stepping into the 1099 space, whether for more freedom, more income, or more control over your career, you’re not alone. This shift is already happening, and it’s not a trend. It’s a transformation.
And at RSA, we’re here to help you navigate it, on your terms.
James Hensley, Founder, Royal Surgical Associates
References
- American Association of Nurse Anesthesiology. CRNAs Provide Nearly 50 Million Anesthetics Annually. Published 2023.
- Sun EC, et al. Anesth Analg. 2020;130(5):1302–1309. doi:10.1213/ANE.0000000000004274
- American Hospital Association. TrendWatch Chartbook 2023. https://www.aha.org
- NursingProcess.org. CRNA Salary Trends. https://www.nursingprocess.org
- VMG Health. CRNA Compensation Trends. https://vmghealth.com
- IRS. Solo 401(k) Contribution Limits. https://www.irs.gov/retirement-plans