Facing rising costs, staffing shortages and mounting payer pressure, ASCs must sharpen their competitive edge.
Eight ASC leaders joined Becker’s to discuss their top strategies for financial sustainability over the next few years.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What are your organization’s top ASC or outpatient priorities over the next few years to remain competitive and financially sustainable?
Jenny Bono. Administrator of the Joint Replacement Center of Louisiana (Lake Charles): Joint Replacement Center of Louisiana is focused on growth opportunities to maintain competitive advantages as the reimbursement continues to favor the ASC setting for robotic joint replacement surgery. Our immediate attention is on optimizing operational challenges such as supply utilization, staffing shortages, and rising implant and anesthesia costs.. We’re advancing strategies to overcome these challenges by enhancing processes, leveraging automation, and applying lean management practices. Our trusted vendor partnerships are instrumental in achieving our strategic growth objectives, including the integration of the Stryker Mako 4.0 system to further enhance our technological capabilities (as noted in the press release).
Peter Bravos, MD. Chief Medical Officer of Sutter Health Surgery Center Division (Sacramento, Calif.): Our organization is focused on expanding outpatient capabilities, optimizing operations through data-driven insights and investing in workforce growth to sustain clinical excellence. We’re also strengthening partnerships with payers and physicians to improve alignment, expand access and ensure long-term success in an evolving healthcare landscape.
Gregg Florentin. CEO of Tri-City Cardiology Group (Phoenix, Ariz.): For our organization, cardiology remains a top strategic priority. We’re focused on expanding outpatient cardiac capabilities, including diagnostic, interventional and overnight recovery services, within ASC environments. This model not only improves access and efficiency but also aligns with payer incentives and patient preferences. Over the next few years, our goal is to build a scalable, physician-led cardiac microhospital platform that delivers high-quality care while remaining financially sustainable.
Ashley Hilliard, RN. Administrator of the Piedmont Outpatient Surgery Center (Winston-Salem, N.C.): First, we need to continue to implement lean operations to reduce case time, turnover time, and overhead. In addition, it will be important to stay ahead of CMS regulations, state licensure changes and quality reporting requirements. This ensures we do not miss out on any reimbursement due to lack of reporting. Finally, it will be important to negotiate better payor contracts when able and utilize the GPO to achieve maximum savings.
Phyllis Norton. Administrator and Operations Manager of Central New York Eye Center (Poughkeepsie): To remain competitive and financially sustainable, it will be essential for ASCs to integrate artificial intelligence into daily operations. AI technology can significantly enhance efficiency by automating time-intensive tasks and allowing clinical staff to focus on direct patient care.
One immediate application is the use of AI for preoperative and postoperative patient communications. AI systems can conduct routine phone calls to confirm appointments, provide preoperative instructions, and follow up on postoperative recovery progress. This automation frees nursing staff from these labor-intensive tasks, reducing burnout and allowing them to dedicate more time to patients in the center.
Additionally, AI can be configured to identify and alert nurses when patients exhibit concerns or symptoms that fall outside the expected recovery process. This ensures timely intervention while maintaining a high standard of patient safety and satisfaction.
John Petroni. Managing Owner at Silver State Surgery Center (Las Vegas):
1. We aim to leverage artificial intelligence to streamline our administrative processes, enhancing efficiency and reducing overhead costs. We are also looking to implement an AI billing program as well.
2. We plan to work closely with payers to develop bundled payment rates for the proposed 2026 CMS additional codes, with a particular focus on advanced spine procedures utilizing our 23-hour observation capabilities.
3. We are committed to continuing to foster and maintain our positive workplace environment. Through these goals, we will continue to build a positive patient and physician environment, while making the workplace environment a great place to work for our nursing and administrative staff. This approach will not only enhance our corporate culture but also improve employee retention.
4. Our ongoing efforts will include a thorough analysis of purchasing channels to identify opportunities for reducing disposable and implant costs, thereby reducing our overall expenditures.
These key priorities will guide our strategic initiatives over the next few years, ensuring that we remain competitive and continue to be financially sound.
Michael Powers. Administrator of Children’s West Surgery Center (Knoxville, Tenn.): Our center’s top priorities are as following:
1. Workforce, staffing and perioperative care model changes: Continue to be a workplace that attracts top talent and retains staff. We are considering partnering with local nursing and tech schools to become a clinical rotation site. We will continue to create an attractive and collaborative environment for anesthesiology. Endless efforts to drive efficiency and by networking to find any opportunities to redefine workflow that creates synergy between staff, anesthesia and surgeons while maintaining or improving patient/family experience.
2. Payment and regulatory changes will reframe margins: Staying on top of regulatory and payment trends for our region/market. We will be proactive with contract negotiations with payers to ensure market transparency and parity.
3. Surgeon succession planning and recruitment: Again, being proactive and communicating with aging surgeons and succession planning. In addition, growing volumes in specialties that offer positive margins.
4. Technological integration: Continuing our path to fully implement HER and adoption of more applications to streamline costing/case as well as reduction in duplication, staff worked hours and creating more efficiencies.
Bernadette Purser, RN. Senior Administrator of Ambulatory Surgery at VCU Health (Richmond, Va.): We plan to continue to shift high-demand procedures to the ASC setting. We aim to increase procedural volume and expand access to position our organization as a leader in the ambulatory surgical space. This strategic shift will optimize hospital resources and reduce costs associated with inpatient care. We will also enhance cost management and revenue cycle processes to stay strong financially.
