Greg DeConciliis, administrator of Boston Out-Patient Surgical Suites and president of the Massachusetts Association of Ambulatory Surgery Centers, told Becker’s that he sees volume growth and operational discipline as the clearest path through today’s cost pressures.
“The only solution is the old adage of ‘volume cures all,’” Mr. DeConciliis told Becker’s.
By closely managing staffing expenses and building more efficient workflows, ASCs can increase case volume and in turn steady their financial footing.
“More volume equals more revenue,” he said. “And therefore it fixes some of these other problems we’re dealing with — lower margins, high supply costs, high implant costs.”
For Mr. DeConciliis, efficiency starts in the schedule. He pointed to the importance of maximizing block time and eliminating friction that limits throughput.
“Block utilization is key,” he said. “All leaders need to be as efficient as possible, getting more throughput.”
Beyond the cadence of the OR day, education and standardization around supplies are another lever. Mr. DeConciliis emphasized that even small shifts in how teams open and use products can add up quickly.
“If you can reduce your supply and implant costs by not opening stuff you don’t need and reducing waste, you can lower that expense item and help your bottom line,” he said.
The opportunity is especially significant in orthopedics, he added, where supply and implant pricing has not returned to pre-pandemic levels.
“Supply and implant costs haven’t normalized since they shot up during COVID-19,” Mr. DeConciliis said. “So the cost of us doing business and the cost of our procedures continues to stay static — or more importantly, devastatingly increase.”
At the same time, he’s seeing a continued shift in case mix that is likely to push volume higher, but also brings additional cost complexity. On his end, total joints and spine cases are rising, as are Medicare cases tied to an aging patient population.
“We expect that shift to continue in 2026, now that we have the ability to accommodate all these surgeries and ramp up these programs,” he said.
Mr. DeConciliis is also seeing more complex sports medicine procedures moving into the outpatient setting, including synthetic ACL reconstructions. Those cases can improve growth and market positioning, but often require higher-cost implants, reinforcing the need to chase efficiency while staying vigilant on expenses.
“We’re finding more complex sports cases, which again come with higher supply and implant costs,” he said. “So it’s a little catch-22.”
