As reimbursement pressure intensifies and payers accelerate site-of-service shifts, ASCs are entering 2025 facing a payer landscape that is becoming increasingly unpredictable.
Andrew Lovewell, CEO of Columbia Orthopaedic Group, joined Becker’s to discuss how payer dynamics are evolving and where his organization is investing next.
Editor’s note: This interview was edited lightly for clarity and length.
What’s one word to describe the ASC payer environment in 2025?
Andrew Lovewell: Volatile. In 2025, the ASC and physician practice payer environment is volatile because reimbursement pressure, site-of-service shifts, and payer policy changes are happening faster than leaders can operationalize them. ASC leaders are navigating tightening rates, increasing prior authorization requirements, and an onslaught of payer audits/recoupments/takebacks, all while trying to serve patients. The challenge isn’t just about lower reimbursement; it’s the uncertainty about whether we will actually receive payment for our services. Payers are becoming more bold with their tactics, and successful ASCs are doubling down on operational efficiency to fight these compounding issues.
What’s your top investment priorities for 2026
AL: In 2026, access to orthopaedic care will be the defining investment priority as demand continues to grow. We are investing in expanded clinic footprints, advanced practice providers, and streamlined care pathways to reduce wait times. Our practice will be adding more tools to create a hyper-focused digital front door, allowing patients to schedule appointments at any time from their phone. Improving access is not just a patient satisfaction issue; it directly impacts downstream surgical volume and financial sustainability. Organizations that put access first will be the market leaders of the future.
