For anesthesia groups
See what the fifth room really costs.
Supervising physicians come in whole people, so staffing cost climbs in steps, not a straight line. Change the rooms, the ratio and the pay below. Every number is yours to edit, the math is shown, and nothing leaves your browser.
Planning tomorrow across several sites? Plan a day · How the math works
Keelwright · what-if report
Illustrative model built from the assumptions below · Source: keelwright.app · Formulas: keelwright.app/how-it-works · Printed
This schedule costs $2,812,500 a year with a 1:4 care team, $62,500 less than MD-only. One more 6:30a–2:30p room adds $250,000 a year.
- Care team (MD + CRNA)
- $2,812,500
- $11,250 a day
- MD-only
- $2,875,000
- $11,500 a day
- Lowest-cost mix
- $2,375,000
- arithmetic floor, not a staffing recommendation
Rooms
Each row is a group of rooms that run the same hours.
- Rooms
- Rooms
Supervision ratio
One physician to at most 4 rooms. Your number, not a rule we assert.
Pay
Annual, per full-time person. Type it however you like: $416,000 or 416k.
Overtime or locum rate on every staff-hour after this time.
Paid hours per FTE
Lower these to the hours people actually work if you want paid time off counted in the hourly cost.
The cost cliff
Room 5 costs $750,000 a year, 3 times room 4’s $250,000, because it needs another supervising physician 6:30a–2:30p.
Light bars: care team cost · solid black bar: where you are · grey dashed line: MD-only cost · red dashed line: the bar after it needs another supervising physician
Show the numbers as a table
| Total rooms (adding 6:30a–2:30p rooms; others unchanged) | Care team | MD-only | Note |
|---|---|---|---|
| 1 | $1,312,500 | $875,000 | |
| 2 | $1,562,500 | $1,375,000 | |
| 3 | $1,812,500 | $1,875,000 | |
| 4 | $2,062,500 | $2,375,000 | |
| 5 | $2,812,500 | $2,875,000 | you are here · +1 MD |
| 6 | $3,062,500 | $3,375,000 | |
| 7 | $3,312,500 | $3,875,000 | |
| 8 | $3,562,500 | $4,375,000 | |
| 9 | $4,312,500 | $4,875,000 | +1 MD |
| 10 | $4,562,500 | $5,375,000 | |
| 11 | $4,812,500 | $5,875,000 | |
| 12 | $5,062,500 | $6,375,000 | |
| 13 | $5,812,500 | $6,875,000 | +1 MD |
| 14 | $6,062,500 | $7,375,000 |
At the cliffs
With these rates, an anesthesiologist working alone costs less for the first room past each cliff, and the same at 2; beyond that, a new supervision team costs less.
- 6:30a–2:30p: 1 room with an anesthesiologist working alone, the rest under 1 supervising physician costs $250,000 a year less than the care team.
- 2:30p–6:30p: an anesthesiologist working alone in the room costs $187,500 a year less than the care team.
Through the day
| Time | Rooms | Supervisors | Care team | MD-only | Lowest-cost mix | Could add without a new supervisor |
|---|---|---|---|---|---|---|
| 6:30a–2:30p | 5 | 2 | $9,000 | $10,000 | $8,000 | 3 |
| 2:30p–6:30ppremium | 1 | 1 | $2,250 | $1,500 | $1,500 | 3 |
| Day | $11,250 | $11,500 | $9,500 |
Room to grow: 3 more rooms 6:30a–2:30p; 3 more rooms 2:30p–6:30p with no additional supervising physician.
What changing the ratio costs
| Ratio | Care team a year | vs. 1:4 |
|---|---|---|
| 1:2 | $3,312,500 | +$500,000 |
| 1:3 | $2,812,500 | same |
| 1:4current | $2,812,500 | — |
| 1:5 | $2,312,500 | −$500,000 |
People this implies
The care team for this schedule needs about 2.40 physician FTEs and 5.29 CRNA FTEs, at 2,080 and 2,080 paid hours a year over 250 operating days.
Hourly cost: physician $250, CRNA $125, loaded.
Every assumption
Values marked sample are illustrative.
- Rooms
- 4 × 6:30a–2:30p; 1 × 6:30a–6:30p · sample
- Max supervision ratio
- 1:4 · sample
- Physician pay (annual)
- $416,000 · sample
- CRNA pay (annual)
- $208,000 · sample
- Benefits load
- 25% · sample
- Paid hours per FTE
- physician 2,080, CRNA 2,080 · sample
- Late premium
- +50% after 2:30p · sample
- Operating days a year
- 250 · sample
- Chart adds rooms to
- 6:30a–2:30p · sample
All 4 numbers behind this answer are still the sample: physician pay, CRNA pay, benefits load, maximum ratios.
Not included: revenue; call pay unless you enter it; minimum shift lengths; breaks and relief; handoff overlap; non-room duties (pre-op, PACU, blocks); overnight blocks; vacancies and recruiting; case volume, case length, and utilization; what any payer, CMS, or state requires. “Supervision” is used in its plain operational sense, not as a billing category.
Not included
- Revenue
- Call pay unless you enter it
- Minimum shift lengths
- Breaks and relief
- Handoff overlap
- Non-room duties (pre-op, PACU, blocks)
- Overnight blocks
- Vacancies and recruiting
- Case volume, case length, and utilization
- What any payer, CMS, or state requires
“Supervision” means one physician responsible for several rooms, in the plain operational sense. It is not a billing category.
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