Nearly every hospital and health system plans to keep putting capital into ASCs, according to the 7th Hospital Leadership ASC Survey from Avanza + MedHQ, conducted with HealthLeaders Media. Ninety-six percent of respondents plan continued ASC investment or affiliation in the coming years. Just 4% have no plans to invest further.
That share has risen across past editions of the survey. In 2021, more than 6 in 10 hospitals and health systems planned to increase ASC investments. By the 2023 edition, more than 7 in 10 intended to keep investing in and affiliating with ASCs.
Five more findings:
- Seventy-five percent of respondents describe their planned pace as aggressive or moderate, while 63% expect modest expansion, 21% will expand only as opportunities arise and 12% plan rapid expansion.
- Eighty-nine percent have at least one ASC affiliated, owned or under development, and 53% report five or more. In 2021, 46% of hospitals and health systems had at least one ASC.
- Among hospitals with an ASC, 85% own or affiliate with two or more. In 2021, 61% of ASC owners had two or more.
- More than 9 in 10 respondents want at least a 50% stake in their ASCs, and 12% want full ownership.
- Among the 11% without an ASC, regulatory obstacles such as certificate-of-need laws were the most-cited reason, at 35%. Another 24% said they have one in progress.
The survey lands as health systems move more capital into outpatient surgery. Becker’s has tracked several health systems investments into ASCs in 2026, and CMS is phasing out the inpatient-only list and added 560 procedures to the ASC covered procedures list for 2026 alone.
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.
