A few years ago, 1099 work found you. Recruiters called, groups competed, and a free weekday could turn into a contract.
Here on the East Coast, that has quietly changed. Compared with 2021, the 1099 roles I see have shrunk to almost nothing. Nearly everything now is W-2.
So I went looking for the numbers.
The short answer
Record numbers of new CRNAs are graduating, programs are up 21% in five years, and the federal government’s own projection now shows a surplus. Pay data still looks strong, but it runs a year or more behind. Contract work moves first, and even the AANA now says 1099 demand growth is slowing and leveling off in some markets. The national surplus isn’t here yet. The early signs are.
We’ve been told this before
Anesthesia workforce forecasts have missed before, in both directions. Here’s the track record.
| When | The prediction | What happened |
|---|---|---|
| 1994 | An ASA-commissioned report said residencies trained 30% too many anesthesiologists | Programs cut back, and by the late 1990s the specialty was short |
| 2010 | RAND projected a CRNA surplus of about 7,970 by 2020 | It never came; outpatient, GI and office anesthesia grew faster than modeled |
| 2000s to 2015, Ontario | Six or more studies predicted an anesthesiologist shortage | By 2015 Ontario had a surplus |
| 2000s to 2010s, pharmacy | A school boom pushed graduates past 12,000 a year | New grads stopped getting early offers, and pay went flat |
Here’s what that history teaches.
Forecasts miss, so headlines aren’t proof. The 1994 “glut” set up the next shortage (Enhance Healthcare). RAND’s 2020 surplus never came, because demand grew faster than anyone modeled (RAND).
Money can create a surplus even when headcount says shortage. Ontario had plenty of patients. It didn’t have the budget to hire, and new grads clustered in the cities (Can J Anesth). Today’s parallel is payer pressure: commercial insurers are cutting rates for non-medically directed CRNA care.
When a boom overshoots, it doesn’t look like unemployment. Pharmacy is the clearest warning. Nobody was out of work. Offers got thinner, pay stopped rising, and negotiating power quietly moved to employers (Drug Topics). Applications fell every year from 2010 to 2015, but the correction took years.
That last pattern is the one to watch. It’s also what the 1099 market looks like right now.
The pipeline in numbers
After 13 nearly flat years, the number of CRNA programs jumped, and new-CRNA output hit a record in 2025.
| Measure | 2021 | Now | Change |
|---|---|---|---|
| Accredited programs | 128 | 155 (2026) | +21% |
| Active clinical sites | 2,161 | 2,819 (2026) | +30% |
| Passed boards on first try | 2,216 | 2,980 (2025) | +34% |
Programs and sites: NJANA (Aug 2021) and Above the Drapes (Mar 2026). Board results: NBCRNA annual reports.
The pipeline
New CRNAs per year are up 46% since 2019
CRNAs passing the national certification exam on their first try, each year
Source: NBCRNA NCE & SEE annual reports, 2015–2025. 2015–2018 are Sept–Aug fiscal years; 2019 on are calendar years. Counts first-time passers only; repeat passers add ~300–400 a year. 2023 per that year’s report (later revised).
In plain terms: from 2015 to 2019, the field added about 2,065 new CRNAs a year. In 2025 it added about 3,000 on the first try, and about 3,300 counting retakes. That’s the most ever.
The 2024 dip is most likely the move to 36-month doctoral programs, which held one class back. NBCRNA doesn’t say so; that’s our read.
The bigger wave hasn’t graduated yet. Many of the 27 newer programs haven’t produced a first class. Students sitting NBCRNA’s self-evaluation exam, a rough stand-in for students in training, rose from 4,450 in 2020 to 8,079 in 2025. That’s up 82%, though some students take it more than once, so treat it as direction, not a headcount.
What the paychecks say (and why they’re late)
On paper, the money still says shortage. Average CRNA pay rose from $181K in 2019 to $231.7K in 2024 (BLS). About 80% of CRNAs got sign-on offers, averaging around $20K (Becker’s ASC).
But look at the dates. Federal wage data is collected once a year and published about a year later. Sign-on bonuses reflect offers already in motion. These numbers tell you where the market was.
If an oversupply is starting, it won’t show up in a salary average first. It shows up where hiring is most flexible: contract work.
The first cracks: 1099 and locums
The contract market is cooling, not collapsing. Here’s what the people closest to it are reporting.
Signs of cooling
| Signal | What the data shows | Source |
|---|---|---|
| 1099 demand | Still high, but growth is slowing and some markets are leveling off | AANA, Oct 2026 |
| 1099 pay raises | About 11% last year, but the pace is slowing and flat in some areas | AANA, Oct 2026 |
| Payer pressure | Insurers can pay about 15% less for non-medically directed CRNA care, which could push hospitals away from 1099 CRNAs | AANA, Oct 2026 |
| Locum bill rates | Forecast to fall in 2025 as facilities push back on cost | Lokum |
| New grads | High demand doesn’t mean an easy search; competition is stiffer in program-dense metros | AANA, 2025; Core Anesthesia |
Signs it’s still hot
| Signal | What the data shows | Source |
|---|---|---|
| Locum demand | CRNAs were the most requested locum specialty, with demand up 55% in a year | CHG, 2025 |
| 1099 share | 19% of AANA members surveyed worked 1099 in 2025, about the same as 2023 | AANA, Oct 2026 |
So which is it? Both, depending on where you stand.
National numbers blend very different markets. A rural hospital with a hard-to-fill call schedule and a busy East Coast metro with three CRNA programs nearby both land in the same average. The hot signals mostly come from the first kind. The cooling shows up first in the second.
The key word is “slowing.” Even the AANA, which is upbeat about 1099 work, now says groups are still hiring contractors, just not as many or as often. That’s the pharmacy pattern from earlier: bargaining power fades before jobs do.
No public dataset tracks 1099 postings by region since 2021. That’s why frontline reports matter. On the East Coast, the 1099 market I watched in 2021 has shrunk to almost nothing. That’s one CRNA’s view, not a survey, but it lines up with where the data says cooling starts.
To be fair: it’s not only supply
Other forces pushed 1099 work toward W-2 at the same time:
- 2021 was an unusual peak. COVID-era backlogs and burnout made contract work scarce and pricey.
- Consolidation. Larger groups and health systems tend to prefer W-2 staff they can schedule.
- Reimbursement. The payer cuts above make contract labor harder for facilities to afford.
- Classification. Facilities are more careful about who they call a contractor, since misclassification carries risk (The Financial Cocktail).
These don’t cancel out the supply story. They stack on top of it, and more new CRNAs every year make it easier for employers to choose W-2.
Is there a CRNA oversupply coming? The next 5 to 10 years
The federal government’s own model says yes: by 2033, about 5,000 more full-time CRNAs than jobs, and about 9,000 by 2038.
| Year | CRNA supply | CRNA demand | Extra CRNAs |
|---|---|---|---|
| 2028 | 68,380 | 66,790 | about 1,590 |
| 2033 | 74,110 | 68,930 | about 5,180 |
| 2038 | 79,540 | 70,400 | about 9,140 |
Full-time equivalents, from the HRSA nursing workforce projections (Dec 2025).
Here’s the simple math behind it. These are rounded estimates:
- New CRNAs each year: about 3,300 now, heading toward about 4,000 by 2028 as today’s students finish (Above the Drapes estimate).
- CRNAs leaving each year: about 1,400, or 2.2% of the workforce (same source, from Census data).
- Net growth: roughly 1,900 more CRNAs a year now, and about 2,500 by 2028.
- New jobs each year: about 530 by the federal labor projection, which runs from 54,500 jobs in 2025 to 59,800 in 2035 (BLS, via ASRA). A high-growth view, assuming 2 to 3% more surgery a year, gets you 2,200 to 3,300.
In plain terms: if demand grows the way the government projects, the field adds about 1,500 to 2,000 more CRNAs than new jobs every year. Stack that up for five to ten years and you get HRSA’s surplus.
Could demand save the day again? It did after 2010, when outpatient and office anesthesia grew fast enough to swallow RAND’s predicted surplus. But that took years of unusually strong growth, and today it would have to outrun record graduating classes and payer cuts at the same time.
What about retirements?
It’s the first question people ask: won’t a wave of retiring CRNAs soak up all these new grads? The math above already subtracts about 1,400 CRNAs leaving each year. But there’s a higher estimate out there too, so here are both.
| Low estimate | High estimate | |
|---|---|---|
| CRNAs leaving each year | about 1,400 | about 2,700 |
| Where it comes from | Actual certification counts | Surveys of retirement plans |
| Net CRNAs added per year now | about 1,900 | about 600 |
| Net CRNAs added per year around 2028 | about 2,600 | about 1,300 |
The low estimate comes from NBCRNA’s own numbers: the count of certified CRNAs rose by about 1,800 in 2025 while 3,235 were newly certified, so roughly 1,400 left (NBCRNA 2025, 2024). The high estimate is an AANA projection that 12% of CRNAs will retire by 2027 (Stout). Net growth is our math, using the new-CRNA figures above.
In plain terms: if the high estimate is right, retirements cancel most of the surplus for the next couple of years. If the low one is right, the gap stays wide.
The evidence leans low. The low number is counted, not planned. The CRNA workforce also isn’t getting older: the average age is 47.2 and has stayed between 46 and 48 for 14 years, and the share of CRNAs 55 and older has fallen from 36% to 28% (Above the Drapes, from Census data). Compare that with anesthesiologists, about 57% of whom are 55 or older. CRNAs in their early 60s are also staying in practice longer than they did a decade ago (same source).
The wildcard is the stock market. A few strong years can push CRNAs who are on the fence into retiring sooner (AANA).
Bottom line: retirements soften the surplus, but they probably don’t cancel it. They may buy a couple of years. The bigger graduating classes coming after 2028 outrun even the high retirement estimate.
What it could look like
These are expectations, not certainties.
- Now to 2028: the squeeze starts where it’s crowded. Fewer 1099 and locum roles in popular metros. More W-2 conversions. Smaller sign-on bonuses and less room for new grads to negotiate. W-2 salaries usually hold up longer than contract rates.
- 2028 to 2033: a real surplus, if HRSA is right. Location choice and contract rates go first. Rural areas and low-density states stay strongest. Alabama, for example, has more than six times California’s CRNA density, so some regions are far more crowded than others.
- Wildcards. Faster growth in procedures would absorb more CRNAs. Limits on clinical training sites could cap class sizes. More payer cuts would make things worse. And if jobs tighten, applications will fall, but that correction takes years to reach the workforce.
What to do with this
None of this means CRNAs are in trouble. It means the easy years of every door being open are ending, and the people who plan for it will do best.
Know your number. When employers have more applicants, the CRNA who knows what a case, a day and a contract are actually worth negotiates from strength. Our guide, Know Your Number, walks through it, and the GasRate calculator on our Tools page does the math for you.
Stay flexible on where. The surplus, if it comes, starts in crowded metros. Rural areas, underserved hospitals and low-density states are likely to stay strong much longer.
Keep skills that are hard to replace. Cardiac, peds, OB, regional, and being the person who takes call. When the market tightens, versatility gets hired first.
If you’re an SRNA or a new grad: this isn’t a reason to quit. It’s a reason to start your search early, keep an open mind on location, and read your first contract carefully. If you’re going the contractor route, our 1099 CRNA starter guide covers the setup.
FAQ
Is there a CRNA oversupply right now?
Not nationally, yet. Pay and locum demand still look strong. But new-CRNA output is at a record, 1099 demand growth is slowing, and the federal projection shows supply passing demand around 2028.
Will new CRNA grads still find jobs?
Yes, for now. The squeeze is in where and on what terms: popular metros and top academic or CRNA-only ASC roles are getting competitive, while rural and underserved facilities still recruit new grads hard.
Is 1099 work gone?
Not nationally. About one in five CRNAs still works 1099. But growth in 1099 demand is slowing, and in crowded markets like the East Coast, the roles have thinned out a lot since 2021.
Is CRNA school still worth it?
For most people, yes. It’s still one of the best-paid nursing roles. Just go in expecting a normal job market, not the 2021 one, and be ready to move for the right first job.
Where is CRNA demand strongest?
Rural areas, underserved hospitals, low-density states, and facilities that struggle to recruit. Outpatient settings like GI, dental and plastics also keep adding anesthesia work.
Sources
- NBCRNA: NCE and SEE annual reports, 2015–2025
- NBCRNA: 2025 Annual Report (certified CRNAs, new certificants, average age)
- Stout: The Anesthesiologist and CRNA Staffing Market
- HRSA: Nursing Workforce Projections Factsheet (Dec 2025)
- AANA: The Current Landscape of 1099 CRNAs (Oct 2026)
- AANA: 2025 Job Market Outlook
- CHG: State of Locum Tenens Report
- Lokum: The CRNA Job Market in 2025
- Core Anesthesia: CRNA Job Outlook
- Above the Drapes: Is the CRNA Field Becoming Oversaturated? (Aug 2026)
- NJANA: CRNA Fact Sheet (2021)
- BLS: Occupational Outlook, Nurse Anesthetists
- ASRA Jobs: CRNA Job Outlook (BLS 2025–35 projections)
- RAND: Is There a Shortage of Anesthesia Providers? (2010)
- Enhance Healthcare: Anesthesia Workforce Shortage, Part I
- Siu et al., Job shortages in anesthesia (Can J Anesth, 2016)
- Drug Topics: Signs of a weakening pharmacist job market (2016)
- Becker’s ASC: The CRNA workforce in 2026
- The Financial Cocktail: 1099 vs. W-2 for CRNAs
For general education only, not career, legal or financial advice. Projections and pipeline math are estimates and may change. No affiliate links in this article. Cover and images: AI-generated via Google Gemini.
