A number of federal policies proposed or enacted in the last year are expected to have a significant impact on ASCs.
In July, CMS released its proposed rules for 2026, which included the addition of hundreds of procedures to the covered procedures list for ASCs as well as a 2.6% bump in reimbursements for ASCs.
Krista Bragg, DNP, CEO of Philadelphia-based KB Kinetics, recently joined Becker’s to share her thoughts on what federal policy moves will provide the biggest benefit to ASCs.
Editor’s note: This response has been lightly edited for clarity and length:
Question: What recent federal policies are the most exciting or concerning for ASCs right now?
Dr. Krista Bragg, DNP: The federal government’s proposed 2026 Medicare rule is largely positive for outpatient surgery centers. If finalized, it would raise ASC payments by 2.4% and add more than 500 procedures, including many orthopedic and joint surgeries that were previously limited to hospitals. Medicare also plans to phase out its inpatient-only list over three years, opening the door for more procedures to move into outpatient settings.
The proposal would also pay surgery centers separately for advanced wound care supplies, improving reimbursement and access to biologic treatments for complex wounds. Together, these changes support the broader shift toward site-neutral payments, where hospitals and surgery centers are paid the same rate for identical services. That shift could make care more affordable for patients and strengthen the long-term sustainability of ASCs, although hospitals may face lower outpatient reimbursement as volumes shift.
UnitedHealthcare recently reduced reimbursement to certified registered nurse anesthetists by 15% for independently billed anesthesia services. CRNAs provide most anesthesia care in rural and smaller communities, making up more than 80% of anesthesia providers in rural areas, and many ASCs rely on CRNA-only coverage to maintain operations. Lower reimbursement could make it harder for these centers to recruit and retain anesthesia providers, leading to delays, canceled cases, or reduced surgical capacity, especially where physician anesthesiologists are scarce.
UnitedHealthcare is one of the nation’s largest private insurers, so this decision could prompt other payers and possibly CMS to consider similar reimbursement reductions.
The American Association of Nurse Anesthesiology has asked federal officials to review whether the policy violates the Affordable Care Act, which bars insurers from paying licensed providers less when they are legally qualified to perform the same services as other providers.
In summary: Medicare’s proposed 2026 rule represents a strong policy tailwind for ASCs, while recent private payer cuts to CRNA reimbursement may create new challenges for access in rural regions.
