Ambulatory surgery centers continue to gain share as hospitals face sustained margin pressure and employers push for lower-cost sites of care. Orthopedics, cardiology and other procedural specialties remain among the fastest-growing outpatient areas, positioning ASCs as a central growth engine across the healthcare landscape.
Against that backdrop, the continued migration of procedures from hospitals to ambulatory surgery centers, combined with rising employer demand for lower-cost care, is accelerating ASC growth, Andrew Lovewell, CEO of Columbia Orthopedic Group, said during an interview with the “Becker’s Healthcare Podcast.”
Columbia Orthopedic Group is a Missouri-based, physician-led musculoskeletal practice that operates a vertically integrated model, including an ASC, imaging, pharmacy, durable medical equipment, real estate and telehealth businesses. Mr. Lovewell said that firsthand exposure to both clinical and operational dynamics has shaped how the organization prepares for continued outpatient growth.
“One of the big things that’s driving that growth is the migration of cases from the hospital to the ASC space,” Mr. Lovewell said. “We see this happening a lot in the orthopedics and musculoskeletal space with spine and total joints. We see this happening in the cardiology space as well.”
Employer-sponsored health plans are also playing a growing role in accelerating the shift to outpatient settings. As self-funded employers look to reduce healthcare spending, many are actively steering employees toward ASCs.
“I think also one of the big things that’s making that transition possible is the self-funded health plans; employer-sponsored healthcare,” he said. “Employers are trying to save cost on what they’re providing for their employees, and they’ve shifted a lot of their demand towards the ASC space.”
That shift is increasingly being reinforced through benefit design, with employers encouraging employees to choose lower-cost sites of care.
“You’re also going to see more employers offer free or reduced cost on their health plan to people who choose that route because it does provide a savings to the employer group when they’re providing those benefits to the employees,” Mr. Lovewell said.
As employers and payers continue to influence site-of-care decisions, ASC leaders should proactively communicate the value they bring to the healthcare ecosystem.
“You have power and you have value that’s very hard to match because what we can do in an ASC versus a hospital or a larger tertiary care center is so valuable,” he said. “Employers want it.”
Operational readiness comes first
As more procedural volume moves into outpatient settings, Mr. Lovewell said ASC leaders must prioritize operational readiness to avoid bottlenecks and missed opportunities. The current landscape is a “perfect storm” for ASCs to expand.
“ASC leaders have to be ready for that expansion. Do you have all the technology in place? Do you have the staff in place? Or is your block schedule optimized where you can produce at that level?” said Mr. Lovewell.
Preparation should start with core fundamentals, and then ASC operators can pursue more advanced initiatives such as artificial intelligence and sophisticated digital transformation. As ASC volumes rise, technology becomes less about experimentation and more about enabling consistent, scalable operations, particularly for centers still operating without fully integrated systems.
“If an ASC that hasn’t invested in technology yet, and doesn’t have an EHR, doesn’t have an inventory management system or some type of nature there, I would strategically look at that as an opportunity for your next horizon of strategic planning,” he said.
Technology can also play a significant role in reducing administrative burden and improving the patient experience, particularly through automation. Those investments allow staff to focus on higher-value work rather than repetitive administrative tasks.
While interest in artificial intelligence continues to grow across healthcare, ASCs should approach new technology carefully and avoid over-adopting disconnected tools.
“When we get into the AI space and robotics, let’s tiptoe into that cautiously and make sure that it’s going to actually produce value before we explore and purchase the technology,” he said.
He also cautioned against relying too heavily on standalone solutions.
“Anybody can add point solutions, but you’re going to end up with point solution fatigue by just adding and adding and adding to it,” Mr. Lovewell said. “Establishing what it is we’re trying to solve for and who can solve for the most problems at one time is going to be really the key to success there.”
