The ASC industry adapted to numerous disruptions in 2025, from regulatory barriers and reimbursement cuts to an ongoing workforce shortage.
Two ASC leaders recently joined Becker’s to expand on what they saw as the biggest disruptions to their business and operations in 2025.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What were the biggest disruptions to your ASCs’ practice in 2025?
Gregory Rendelman, CRNA. Department of Veterans Affairs (Lancaster, Pa.): I think the most important change in the ASC setting is utilizing [certified registered nurse anesthetists] to their fullest capacity. Anesthesia needs to be leaner and more efficient. You can’t have anesthesiologists supervising 11, 1:2, 1:4, or the need to supervise at all. This is data-driven. A free anesthesia provider to facilitate movement and troubleshoot can be done by any anesthesia provider with the will and the skill.
Jon Van Valkenburg. Executive Director of Upstate Orthopedics Ambulatory Surgery Center (East Syracuse, N.Y.): Definitely anesthesia provider shortages and the consequent increasing costs. ASCs require anesthesia services to deliver most of the care they provide. Increasing competition and decreased reimbursement for anesthesia services have made it a significant cost center for many ASCs. Several years ago, that was not the case. The relatively lower reimbursement rates for ASCs, combined with these increasing costs, have made the business model much more challenging. ASCs are relying on continued growth, particularly of higher-margin procedures, to maintain viability. The anesthesia shortages make that sustained growth even more of a challenge.
