From AI-driven revenue cycle strategy to payer negotiations, staffing strain and surgical workflow redesign, ASC leaders told Becker’s the biggest lessons lately aren’t theoretical, they’re financial and operational realities.
As margins tighten and expectations climb, executives are rethinking everything from how budgets connect to patient experience to how insurers value site-of-care and how teams want to work. The common thread: protecting performance today requires sharper tools, clearer alignment and a willingness to challenge long-standing assumptions about how ASCs operate.
Question: What’s a recent “learning moment” you’ve had as an ASC leader?
Editor’s note: Responses have been lightly edited for clarity and length.
John Beauchamp. Senior Director of Administration, Revenue Cycle and Data Analytics at GI Associates (Milwaukee): A recent learning moment for me has been realizing that AI really isn’t optional anymore, it’s becoming part of everyday financial discipline in ASCs. In revenue cycle and data analytics, we’re leveraging it to enhance data-driven decision-making, better align staffing and approach payer performance more strategically. The takeaway is that leaders don’t have to be AI experts, but we do need to understand how to use these tools wisely to protect margins and make smarter decisions. It’s less about chasing innovation and more about applying the right tools to run a disciplined, high-performing operation.
Ray Brown. CEO of Lake Lucien Surgery Center (Maitland, Fla.): I was recently working on improving logistics numbers for the sterile processing department, and I realized that we need to be able to tie any number back to patient experience, and that every line item we have in our budget, can and should be connected to patient experience. We are sometimes caught up on how we see things from an internal clinical perspective, but I think an important exercise is to try to see it only from the eyes of a patient who is seeing for the first time, and only from the perspective of how it affects them.
Jeffrey Carlson, MD. President of Orthopaedic & Spine Center (Newport News, Va.): Recently, our ASC has been renegotiating pricing with our insurance payers. It has been an eye-opening experience into how little incentive the insurance companies have to decrease their costs.
Price transparency tools allow us to see exactly what different plans pay to the local hospital systems for the same surgeon to do the same procedure. In negotiations, the insurance company will quibble with us for a 1% increase in compensation, while they pay the hospital 300% above our rate. Again, this is for the same surgeon to do the same procedure at a different facility. It would make sense for financial savings to the insurance plan to incentivize patients to have their procedures at an ASC versus the hospital. Our ASC increases access and decreases complications, all while saving costs for patients and the insurance company. Our discussions with insurers eventually only come down to money.
Wayne Gillis. President and CEO of Rehoboth McKinley Christian Health Network (Gallup, N.M.): In a recent budgeting meeting, I faced rising supply and labor costs, flat or declining reimbursement and growing expectations for quality, access, growth and patient experience. My instinct was to focus on cost containment, but I realized the core issue wasn’t cost, it was process.
Despite a committed team, variation in scheduling, preference cards, turnover times and inventory management had normalized inefficiency and was quietly eroding margin. A review of a single surgical day revealed compounding gaps: late starts from inconsistent pre-op readiness, unnecessary supplies on preference cards, turnover processes dependent on who was on shift and implants opened without clear triggers. Individually minor, together they cost more than any line-item cut. The lesson: In a rising-cost environment, leaders must design better systems, not push people to work harder. By engaging frontline staff to standardize workflows and supply practices, costs stabilized and morale improved. Margins improve through process, not pressure.
Thomas Jeneby, MD. Plastic Surgeon in San Antonio: Staffing. People want more flexibility . As a surgicenter, you can never pay them enough to be happy long term. I allow some flexibility in second jobs, as long as it is not a close competitor. I also now realize I cannot make everyone happy with most salaries and payments as the new norm is locum or [pro re nata]pay. I can only tout lifestyle improvement with our team and culture. I can’t find anyone with a one-size-fits-all answer to this as well!
Phyllis Norton. Administrator at Central New York Eye Center (Poughkeepsie, N.Y.):
After 38 years in the same ophthalmic surgery center, I thought I knew every corner, every process and every lesson this field could teach me. Yet, as we prepare to renovate and move into a new facility, I’ve been reminded that growth never really stops. There is so much to learn in this new phase, and instead of feeling overwhelming, it has been energizing. It has renewed my interest, refreshed my perspective and filled me with excitement about the future.
Teresa Tam, MD. Minimally Invasive Gynecological Surgeon and Owner of All for Women Healthcare (Chicago): The simple truth is that proactive communication beats perfect systems. Your referring partners need accessibility, not perfection.
