Certified Registered Nurse Anesthetists (CRNAs) are poised to shape the future of anesthesia care in the United States.
CRNAs are integral providers in a wide range of settings, from large urban hospitals to rural clinics, and their role continues to evolve in response to workforce needs, legislation, and advancements in patient care.
This article explores the latest developments in CRNA practice, including the growing demand for nurse anesthetists, rising compensation, expanding scopes of practice, and the influence of technology.
Let’s take a closer look at the trends defining the industry in 2025.
What Does a Nurse Anesthetist (CRNA) Do?
CRNAs, also referred to as nurse anesthetists, deliver anesthesia services to millions of patients across the country. Each year, they administer more than 58 million anesthetics in diverse settings, including operating rooms, ambulatory surgical centers, and clinics. They have a long-established reputation for patient safety, reflecting nursing’s consistent standing as one of America’s most trusted professions.
CRNAs typically enter anesthesia training after working as registered nurses in critical care settings. As such, they have substantial experience in handling high-acuity and complex cases. Because of this background, they are well-prepared to deliver anesthesia in various environments—hospital operating rooms, obstetric units, intensive care units, outpatient centers, and even frontline military operations.
A key aspect of CRNA practice is their impact in rural and underserved areas. CRNAs make up over 80% of anesthesia providers in rural U.S. counties and often serve as the primary providers of anesthesia where physician anesthesiologists are scarce. In states such as Massachusetts, with around 900 CRNAs, many nurse anesthetists are the main anesthesia providers in rural hospitals, sustaining essential surgical and obstetric care in regions that might otherwise lack services.
CRNAs’ ability to function either independently or collaboratively helps bridge access gaps to anesthesia, which is crucial amid the broader anesthesiology workforce shortage. By 2033, the U.S. could face a deficit of about 12,500 anesthesiologists—nearly 30% of the current physician anesthesiology workforce.
The resulting strain is especially acute in rural areas, which depend heavily on nurse anesthetists to continue vital services. Hospitals are increasingly adopting CRNA-heavy care teams, in which a single anesthesiologist oversees multiple CRNAs, ensuring continuity of surgical schedules amid physician shortfalls.
Beyond administering anesthetics, CRNAs manage patients throughout the perioperative process: they evaluate individuals preoperatively, craft anesthesia plans, monitor life functions during procedures, and oversee recovery.
Many also participate in pain management services and critical care teams, while in the military, they often hold full practice authority and serve as primary providers in forward surgical operations. This wide-ranging scope illustrates why CRNAs are indispensable. Their blend of clinical expertise, leadership in specialized settings, and ability to expand access to anesthesia care underpins the increasing recognition and demand for nurse anesthetists nationwide.
CRNA Trend #1: Higher CRNA Salary
CRNAs remain among the highest-paid nursing professionals. According to the U.S. Bureau of Labor Statistics, CRNAs earned about $205,000 in 2022, rising nearly 10% to $214,000 by 2023. A SullivanCotter survey found that the median total cash compensation reached $221,300 in 2023—a rise of 11% from 2022. The latest reports from BLS put the annual salary for CRNAs at $212,650 per year in 2024.
Geographic variation is substantial. Illinois tops the list with an average salary of $281,000, while states like Massachusetts, California, Montana, and Vermont report averages in the $250,000+ range. In contrast, states like Florida average $177,000, and Utah is the lowest at $125,000.
Bonuses and incentives further boost earnings. Reports show that 69.9% of employers offer sign-on bonuses, typically $15,000, though $20,000–$40,000+ is common in competitive markets. These perks, including relocation assistance and loan repayment, can significantly elevate total compensation.
Drivers of Increased CRNA Compensation
In some cases, CRNAs can earn more. Here are the drivers of that increased compensation.
Expanded Scope of Practice
CRNAs are increasingly authorized to practice independently. As of 2024, 23 states allow CRNAs to work without physician supervision, and many others have relaxed rules or opted out of the federal supervision mandate. This broader autonomy increases CRNA value, especially in rural areas, driving salaries up.
Recruitment Incentives
To secure CRNAs, organizations offer sizable sign-on and retention bonuses. Packages regularly include relocation stipends and student loan repayment. Hospitals are bundling base pay with "lucrative recruitment packages" to attract talent. These offers are especially common in high-need regions and for new graduates.
Cost-Efficiency for Hospitals
Hospitals increasingly use CRNAs because they offer comparable care at a lower cost. CRNA salaries are often half that of anesthesiologists despite similar clinical outcomes. In team models, one physician may supervise multiple CRNAs, improving coverage and savings. Veralon emphasizes that CRNAs enable hospitals to expand services without increasing cost, especially in rural settings.
Malpractice Pressures
With expanded autonomy comes increased liability. Many CRNAs now carry malpractice insurance premiums of about $5,968/year, which is 50% higher than for other non-physician providers. Because they often practice independently, CRNAs incur risk levels similar to anesthesiologists. Employers may offset this risk through higher pay or insurance subsidies.
CRNA Trend #2: Expanding Scope of Practice for CRNAs
The scope of practice for Certified Registered Nurse Anesthetists (CRNAs) has expanded notably in recent years, with an increasing number of states authorizing CRNAs to administer anesthesia without mandatory physician supervision.
As of 2024, 25 U.S. states have exercised the prerogative to "opt out" of the federal requirement for physician oversight, permitting CRNAs to practice independently in accordance with state regulations. In 2024, Massachusetts joined this group by removing supervision mandates, reflecting growing confidence in CRNAs' ability to provide safe, autonomous care. This autonomy enables CRNAs to assess patients, administer anesthesia, and oversee recovery without physician oversight.
Research indicates that anesthesia care provided by CRNAs is comparable in safety and efficacy to that provided by anesthesiologists. A study analyzing over one million obstetrical patients found that anesthesia complication rates in CRNA-only hospitals were 0.23% compared to 0.27% in anesthesiologist-only hospitals.
The study concluded that hospitals employing only CRNAs – or a combination of CRNAs and anesthesiologists – do not have systematically poorer maternal outcomes compared to those using exclusively anesthesiologist models. Such findings support legislative efforts to grant CRNAs greater independence in various healthcare settings.
To support this expanded scope of practice, educational standards for CRNAs have evolved. By 2025, all new CRNAs are required to hold a doctoral degree, such as a Doctor of Nursing Practice (DNP) or Doctor of Nurse Anesthesia Practice (DNAP). These doctoral programs encompass advanced studies in leadership, healthcare policy, and clinical research, equipping graduates for independent practice.
Additionally, many programs offer specialized training in areas like regional anesthesia, pain management, and ultrasound-guided procedures, further broadening CRNAs' competencies in perioperative care.
Practice models have also adapted in response to these legislative and educational changes. Many hospitals have adopted "care team" models that heavily utilize CRNAs, while others have enabled CRNAs to establish independent groups contracting directly with medical facilities, similar to physician-owned anesthesia practices.
These models are particularly prevalent in rural and underserved areas, where CRNAs often serve as the primary anesthesia providers, ensuring patient access to essential anesthesia services. By implementing these models, healthcare systems can address provider shortages, maintain surgical volumes, and uphold high standards of care.
Overall, the combination of independent practice laws, doctoral-level education, and evidence supporting CRNA-provided care continues to enhance CRNAs' role and influence within the medical community.
CRNA Trend #3: Lucrative Opportunities with Locum Tenens CRNAs
An emerging trend for nurse anesthetists in 2025 is the pursuit of locum tenens positions, wherein CRNAs take short-term assignments in high-need areas for premium pay rates. Locum tenens CRNAs can command hourly or daily compensation significantly above typical full-time salaries.
In recent years, many facilities facing staffing challenges or surgical backlogs have turned to traveling CRNAs to cover operating room needs, especially after elective procedures rebounded from pandemic-related slowdowns. Some hospitals offered rates of $275–$325 per hour (or higher) to fill urgent assignments, leading many nurse anesthetists to consider locum work for its financial rewards.
According to industry data, experienced CRNAs opting for locum tenens can earn $250,000 or more per year. In certain scenarios, annualized pay can exceed $300,000 if a CRNA accepts frequent assignments in premium-pay markets.
Staffing agencies also report that some locum CRNA jobs list potential annual compensation from $245,000 to $250,000, depending on location, length of contract, and urgency of need. Beyond compensation, locum assignments grant CRNAs scheduling flexibility and exposure to varied practice settings, letting them choose when and where to work.
Locum tenens opportunities also appear in states that allow independent practice, which can broaden CRNAs’ scope in a temporary role. A traveling CRNA might gain experiences not typically available in a more restrictive state, enhancing clinical proficiency while enjoying competitive compensation.
For healthcare organizations, hiring locum CRNAs ensures uninterrupted surgical volume during vacancies or peak seasons, though it may be costly compared to employing permanent staff. These market forces continue to boost the popularity of locum tenens among nurse anesthetists seeking to optimize both earnings and work-life balance.
CRNA Trend #4: Growing Demand for CRNAs
The U.S. Bureau of Labor Statistics projects a 38% growth in employment for CRNAs from 2022 to 2032, a rate that far outstrips averages for most healthcare professions. This expansion equates to tens of thousands of new positions over the next decade.
For perspective, the BLS anticipates 31,900 annual openings for nurse anesthetists, nurse midwives, and nurse practitioners combined through 2033, many of which will be allocated to nurse anesthetists. Multiple forces are fueling this increased need: an aging population that requires more surgeries, advances in outpatient surgical procedures, and the retirement of many current anesthesia professionals.
Outpatient centers and ambulatory surgery clinics are expanding rapidly, creating more operating rooms outside traditional hospitals. These facilities often depend on CRNAs to staff multiple procedure rooms efficiently, especially when they can practice with autonomy in states that have adopted independent practice regulations.
Concurrently, the retirement wave among anesthesiologists is intensifying. As we’ve noted earlier, more than 30% of anesthesiologists are age 55 or older, meaning a large cohort will exit the workforce over the next decade. CRNAs, too, are facing retirements—12% plan to retire by 2027—opening up further vacancies.
Cost pressures also factor into this dynamic. Hospitals and clinics must manage budget constraints even as demand for anesthesia services grows. Since CRNAs generally command lower salaries than physician anesthesiologists, employing a higher proportion of nurse anesthetists can maximize surgical coverage with fewer resources.
This cost-effective model often leverages CRNA-led teams in both urban and rural settings, further augmenting the demand for nurse anesthetists.
While the pipeline of future CRNAs is robust—around 8,500 students enrolled in 133 accredited nurse anesthesia programs in 2023—these graduates take several years to complete doctoral training before they can fill workforce gaps. Until then, existing providers will remain in especially high demand.
New graduates and seasoned CRNAs alike report multiple job offers, allowing them to choose practice settings that align with their goals and preferred locations. This landscape, marked by a growing surgical population and an urgent need for anesthesia services, ensures nurse anesthetists a secure and expanding career path.
CRNA Trend #5: Gender Diversity and Workforce Composition
Unlike many nursing specializations that remain predominantly female, the CRNA field stands out for its near gender parity. While men comprise just 11–12% of the broader registered nurse workforce, nearly 47% of CRNAs are male.
High earning potential, clinical autonomy, and leadership opportunities likely contribute to this balanced gender representation. Women, likewise, continue to thrive in nurse anesthesia, including in roles as chief CRNAs, academic leaders, and executives within professional organizations.
Overall, there are approximately 57,000 actively practicing CRNAs in the United States. Most—around 87%—work directly in clinical capacities. Of these, a significant proportion (about 18%) practice as independent contractors rather than traditional employees, reflecting the growing preference for 1099 or locum arrangements.
The largest single employment segment is hospitals (about 41%), followed by private anesthesia groups, outpatient centers, and other settings. A smaller fraction practice in military or Veterans Affairs systems, often with full practice authority.
Demographically, around 31% of CRNAs are age 55 or older, which is why nearly one-third of the workforce could retire in the next 10 to 15 years. This generational turnover could strain anesthesia services unless incoming CRNAs fill the ranks.
Burnout also remains a concern—56% of CRNAs report experiencing it—potentially leading to reduced hours or early retirement. Professional organizations like the American Association of Nurse Anesthesiology (AANA) have responded by emphasizing wellness initiatives and mentorship for newer CRNAs.
Despite these challenges, overall job satisfaction is high: 95% of CRNAs say they are satisfied or very satisfied with their career choice. The blend of autonomy, meaningful patient impact, and strong compensation continues to attract a diverse talent pool, ensuring that the CRNA profession remains vibrant and dynamic.
CRNA Trend #6: The Rise of AI, Robotics & Digital Tools in Anesthesia
Technological innovations are rapidly reshaping anesthesia practice, and CRNAs often lead the way in implementing new tools to enhance patient safety and efficiency. Here’s an overview:
Among the most notable developments are artificial intelligence (AI)–driven monitoring systems, which analyze real-time patient data to detect subtle signs of instability. For instance, platforms like Masimo SafetyNet™ use continuous analytics to alert providers to trends in vital signs that may be difficult to catch through manual monitoring alone.
By automating data analysis, these systems enable CRNAs to focus on clinical decision-making and individualized care, thereby improving patient outcomes.
Preoperative assessment has also been influenced by AI. Predictive models can review patient records, lab findings, and surgical histories to estimate complication risks, helping CRNAs plan tailored anesthesia strategies.
For example, identifying patients prone to severe postoperative pain allows CRNAs to optimize pain management protocols. This proactive approach extends care beyond anesthesia induction alone, improving recovery and reducing complications.
Telehealth and remote care models have begun to surface in anesthesiology as well. Some large health networks use centralized “anesthesia control towers,” in which an off-site team, including CRNAs, supports local providers via video feeds and real-time data streams.
This concept allows seasoned clinicians to advise those in smaller or rural hospitals, breaking down geographic barriers. Tele-anesthesia can also facilitate preoperative assessments for patients who live far from a surgical center.
By expanding reach in this way, CRNAs enhance access to safe perioperative services.
In daily practice, CRNAs are adopting ultrasound-guided regional anesthesia, advanced airway devices, and target-controlled infusion systems—innovations that refine surgical pain management and patient safety. Ultrasound-guided blocks, in particular, have minimized complications and improved postoperative outcomes by precisely delivering local anesthetics.
Some research groups are even exploring automated or robotic assistance for intubation and IV insertion, although these technologies remain in the early stages. As these tools mature, CRNAs’ expertise and patient-centered perspective will guide safe implementation, ensuring technology serves as an adjunct to—rather than a replacement for—clinical judgment.
Looking ahead, further integration of AI and smart systems is expected. Algorithms may eventually recommend patient-specific anesthetic dosages based on genetics, comorbidities, and real-time responses, which CRNAs would then confirm or refine. This next generation of personalized anesthesia promises to make surgeries safer and more efficient.
For CRNAs, maintaining a leadership role in technology adoption ensures they stay at the cutting edge of perioperative care while preserving the human elements of empathy and communication essential to high-quality clinical practice.
Leverage CRNA Industry Trends to Stay Ahead
The CRNA field is entering 2025 with growing autonomy, expanded roles in rural and underserved areas, and increased demand driven by healthcare access challenges.
Technology adoption, including AI-assisted anesthesia tools and telehealth integration, is reshaping how CRNAs deliver care and collaborate within medical teams.
Workforce shifts, such as rising retirements and competitive compensation trends, are influencing recruitment strategies and educational pathways.
These trends aren’t speculative—they’re already reshaping the profession, and staying ahead means adapting in real time.
If you’re looking to recruit CRNAs for your organization, reach out to AAG/H to see how we can help.
Frequently Asked Questions
What are the changes for CRNAs in 2025?
In 2025, CRNAs are seeing expanded practice authority in more states, continued implementation of the Doctor of Nursing Practice (DNP) as the entry-level degree, and increased demand in rural and underserved areas. Reimbursement policies and scope-of-practice laws are also evolving to support more autonomy.
What is the future outlook for CRNAs?
The CRNA profession has a strong outlook, with high job demand, competitive salaries, and growing recognition of their role in delivering anesthesia care. The Bureau of Labor Statistics projects above-average job growth through 2032 due to ongoing healthcare needs and provider shortages.
Will CRNAs become oversaturated?
While some regions may experience temporary saturation due to program growth, the overall national demand remains high. Job availability typically follows geographic and healthcare access trends, especially favoring areas with physician shortages.
Is there a CRNA shortage?
Yes, many areas in the U.S. continue to face a CRNA shortage, especially in rural and underserved communities. This is driven by the aging population, increased surgical needs, and a limited number of anesthesia providers.
Will CRNAs replace anesthesiologists?
CRNAs are not replacing anesthesiologists but often work independently or collaboratively, depending on state laws and facility policies. Both roles are essential, with CRNAs helping to fill care gaps and expand access, especially in high-need areas.
