When will managed care come to anesthesia?

Managed care has begun to reshape many areas of health care practice, but anesthesia is not yet among them. The economics of anesthesia care are characterized by widespread inefficiency in the allocation of labor, and a unique market structure that poses special challenges to managed care influence. The potential for savings is great, perhaps as much as a one percent decrease in commercial health costs. But these savings can only be realized if managed care organizations are able to restructure the incentives facing anesthesia professionals to promote innovation, cooperation, and shared benefits of efficiency improvements.