Health systems that keep resisting the shift to ASCs are putting their financial future at risk, according to Regent Surgical CEO Travis Messina.
Asked what is at stake for systems unwilling to adapt, Mr. Messina told Becker’s: “To be blunt, their viability.”
“The financial sustainability of the ASC model is proven,” he said. “Patients will self-select and go to the systems that offer this as an option, and as a result of that, they will be challenged financially.”
Friction persists
Despite the growth of outpatient surgery, Mr. Messina said he still sees significant pushback from hospitals.
“As proven as the ASC model is, there are a tremendous number of health systems that just put up a tremendous amount of resistance to accepting it as a standard of care,” he said.
That resistance is pushing payers to act more aggressively, Mr. Messina said. He pointed to Elevance Health, which announced Sept. 29 it will require hospitals to report where care was physically delivered on claims. The insurer plans to pay certain off-campus services at off-campus rates rather than hospital outpatient rates, with the policy rolling out through the end of 2027 across its commercial, Medicare Advantage and Medicaid plans.
“Patients want this. Patients need this in order to control cost,” Mr. Messina said. “The health plans are trying to make it a viable option for patients in the communities, and thus I still see that friction.”
Federal policy is adding pressure. CMS began phasing out the inpatient-only list in 2026, opening 271 additional procedures to ASCs in the first year.
The alternative: partner
Regent’s newest venture shows what the other path looks like. The company is partnering with Penn Medicine and Independence Blue Cross to develop at least 18 ASCs across Pennsylvania, New Jersey and Delaware, with the health system and payer both holding ownership stakes.
Mr. Messina said the model works when a health system and payer stop treating each other as opponents.
“The willingness to recognize that you’re not adversaries, and you’re stronger together, is essential,” he said.
Regent has built its business on joint ventures with academic medical centers, many of which were historically resistant to outpatient surgery. The company now operates 40 sites across 15 states.
“The industry changed, and you’ve got to be willing to try new things,” Mr. Messina said.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
