While health systems and ASCs once viewed each other as competitors, the dynamic has evolved in recent years as ASCs solidify their place as a way to enhance patient experience and operational efficiencies while saving on costs.
Here’s what five leaders have told Becker’s in the last year about the shifting dynamic between ASCs, hospitals and health systems:
1. Steven Hanks, MD. President and CEO of St. Peter’s Health Partners (Albany, N.Y.) and St. Joseph’s Health (Syracuse, N.Y.): “That shift from an inpatient focus to an outpatient focus is one that’s been going on for some time, but it really started to take hold in 2025, and I think the timing could not be better. H.R. 1, also known as the One Big Beautiful Bill Act, is going to take quite a bit of revenue out of the healthcare system over the next several years. I think all of us are looking at our cost structure and how we maintain the high quality of services and keep them accessible to our communities, and at the same time maintain financial sustainability.”
2. Jim Freund. Managing Partner for Physician Transaction Advisors: “[Hospitals] are either going to be part of [the outpatient migration] or they’re going to lose in that race. So you see all the big consolidators out there, and even the smaller ones are creating partnerships with healthcare systems, whether it’s an independent or a joint venture group.”
3. Karen Reiter. Vice President of Operations and Payer Management at TriasMD and DISC Surgery Centers (Newport Beach, Calif.): “ASCs have always been an exciting field. However, they have definitely come into their own and grown at an extremely fast rate. I’m very excited with how surgery centers are changing, the types of cases they’re taking, the adoption within the community and the way that ambulatory is becoming a very strong, established piece of every community.
It’s not a ‘them versus us’ mentality anymore. This ongoing collaboration is a great thing to see and will take us where we want to go.”
4. Alejandro Badia, MD. Hand & Upper Limb Surgeon at Badia Hand to Shoulder Center (Miami): “I believe that healthcare systems are finally realizing that current healthcare costs are unsustainable and that outpatient surgery is much more cost-effective. It is then easier and cheaper to acquire than to build de novo. That being said, many surgeons are finally realizing the value, and power, that we do have in the healthcare marketplace and there is little reason for us to be acquired as long as we hire good administrators and nursing staff. The challenge will continue to be the payors and anesthesia services.”
5. Michael Boblitz. CEO of Athens (Ga.) Orthopedic Clinic: “Partnering with leading health systems in local markets is always a worthwhile goal to evaluate. Regional health systems can offer a very complementary footprint to private orthopedic practices with several locations for access to local hospital care. In addition, leading regional health systems operate broad ambulatory networks with primary care and other specialties that require local access to leading orthopedic practices.
The devil is always in the details, as many hospital and health systems make the mistake to view partnerships as more one-sided where they attempt to have some level of control — via professional services agreements or employment agreements — in exchange for some higher compensation arrangement that is often short lived and reduced at the time to review the next term —or not.
A true partnership offers a win-win, where models such as co-management or service line agreements are deployed that align the private orthopedic practice with the health system around common growth and quality goals. With such win-win arrangements a parallel joint venture ambulatory surgery center partnership next makes sense to unify financial interests — and distributions.”
