ASC leaders head into 2026 with many of the same financial pressures, but their priorities are diverging as organizations balance the basics of protecting margins with the investments needed to expand capacity and capture new growth opportunities.
Four leaders joined Becker’s to discuss which financial priority will demand the most attention in 2026.
Editor’s note: Responses were edited lightly for clarity and length.
Question: Which financial priority will take up more of your attention in 2026: reimbursement, cost containment, capital planning or growth? Why?
Megan Friedman, DO. Chair and Medical Director at Pacific Coast Anesthesia: Cost containment will take the lead, specifically through operational efficiency rather than across-the-board cuts. With reimbursement unlikely to improve, the focus must be on aligning staffing to real-time demand, reducing wasted coverage hours, and improving day-of-surgery coordination. Sustainable growth depends on getting this right.
Emma Gimmel, BSN, RN. Director of Nursing at Manhattan Endoscopy Center (New York City): Adding revenue may be the focus while continuing cost containment focus as a daily habit. Growth and revenue work side by side. As a single specialty, we have to open our arms to the option of stepping out of our single focus and contemplate growing pain in adding. Diversity may help overcome the limitations set in single specialty and the lowering reimbursement.
Phyllis Norton. Administrator and Operations Manager of Central New York Eye Center (Fairview): With the relocation and expansion of our ophthalmic ASC facility from two to four OR suites, the organization will be heavily focused on growth initiatives, including increased surgical capacity, service line expansion, including adding general anesthesia and possibly pediatrics, and positioning the facility for long-term scalability. This growth requires significant capital planning to support new equipment, instrumentation purchases and facility renovations, ensuring investments are aligned with projected volume and strategic goals.
While cost containment and reimbursement optimization will remain essential to protect margins during the transition, the primary focus will be on making the right capital investments to safely and efficiently expand operations. Thoughtful capital planning will ultimately enable sustainable growth, improved operational efficiency and stronger financial performance beyond 2026.
Kristen Richards. Vice President of Ambulatory Care at Cardiovascular Logistics: There is tremendous excitement among cardiovascular ASCs for 2026 with the additions of new procedures and codes to the covered procedure list. With the approval of cardiac ablations in the ASC comes great capital planning to acquire the necessary equipment to provide EP procedures in their facilities. Cardiovascular ASCs will need to be strategic in their capital planning and work with their vendors on innovative business models to acquire the capital. The growth potential for 2026 is significant with the expansion of the covered procedure lists for cardiovascular ASCs. You need to understand the covered procedure lists and their codes and collaborate with your physicians to ensure you have the necessary equipment, anesthesia coverage and provide education to your physicians and RCM team on the new codes to maximize reimbursement. Cost containment will be challenging due to the expansion of the covered procedure lists, making standardized vendor agreements an appropriate step to manage rising supply costs.
