ASCs are increasingly embracing “value engineering,” according to Tina DiMarino, CEO of Custom Surgical Partners — designing and operating facilities with efficiency, cost-effectiveness and sustainability in mind.
Ms. DiMarino told Becker’s that at Custom Surgical Partners, an ASC development company founded in 2003 that has developed more than 150 centers, there’s a clear trend in building ASCs “more efficiently, both operationally and structurally.”
Matthew Cavanagh, who specializes in healthcare as a principal of Maumee, Ohio-based CliftonLarsonAllen, told Becker’s the complexity of running an ASC is often underestimated.
“ASCs must meet patient expectations for access and convenience while providing high-quality care and adhering to strict regulatory standards,” he said. “They also face reimbursement and expense pressures — like labor, supplies and technology — similar to hospitals, but without comparable economies of scale. This often means a single administrator is responsible for managing a wide range of tasks.”
As the industry grows, ASCs are increasingly focused on efficiency. Ms. DiMarino said this involves examining everything from finishes and layouts to supply usage and sustainability.
This is particularly true as healthcare costs continue to rise. Healthcare costs for commercial payers are projected to increase by up to 8.5% in 2026, driven by persistent inflation, rising utilization of behavioral health services, and escalating prescription drug spending, according to a new report from PwC’s Health Research Institute.
Howard Mitz, DO, gastroenterologist and owner of Littleton, N.H.-based North Country Gastroenterology, told Becker’s that reimbursement rates are failing to keep pace with expenses.
Dr. Mitz said the biggest financial strain on his practice stems from “insurance companies not keeping up with the rising costs of everything,” from IV solutions and infusions to staff salaries.
On the supply side, Ms. DiMarino emphasized the importance of vendor selection and understanding cost per case.
“There’s growing awareness around reducing unnecessary disposables and focusing on smarter, cost-conscious design without compromising safety or standards,” she said. “Given that costs haven’t stabilized since COVID-19, everyone is more aligned around this mindset.”
Other ASCs are also pursuing similar strategies to maintain financial sustainability.
“Rising device costs have challenged ASCs to be even more innovative in balancing financial sustainability with patient access,” George Hanna, MD, president of New York City-based Vein Clinic and Pain Treatment Center, told Becker’s. “By focusing on efficiency, smarter purchasing strategies, and value-based alignment with payers, ASCs are uniquely positioned to preserve strong performance while ensuring patients continue to benefit from cutting-edge treatments in a convenient, outpatient setting.”
The push toward efficiency also reflects in performance trends. According to HST Pathways’ latest State of the Industry Report, ASCs with just two operating rooms saw 22% year-over-year growth, the highest of any group. In contrast, centers with 15 or more ORs saw an 8% decline.
“These trends suggest a shifting dynamic in ASC performance, with smaller centers thriving while larger ones face headwinds,” the report said.
Industry experts say this may also reflect differences between single-specialty and multispecialty centers.
Dr. Geogy Vennikandam, COO of GI Partners of Illinois, said single-specialty ASCs may be better positioned to navigate reimbursement pressures, including impending Medicare cuts.
“When it comes to tray fees and various cuts, you’re dealing with different specialties,” he said. “Pain is vastly different from GI, which is vastly different from ortho. Too many cooks in the kitchen is when things get messy.”
He noted that as ASCs take on higher-acuity procedures, operational efficiency becomes even more critical.
“The investment required means you need even more efficiency, and I’ve seen it fall apart,” he said.
