ASC leaders across the country are struggling to maintain margins as operational costs continue to climb faster than reimbursement can catch up.
Five ASC leaders recently joined Becker’s to discuss the best ways that ASCs can get ahead of rising costs in 2026.
Editor’s note: Responses have been lightly edited for clarity and length:
Question: What is the No. 1 thing ASCs can do to get ahead of rising operational costs in 2026?
Peter Bravos, MD. Chief Medical Officer at Sutter Health Surgery Division (Sacramento, Calif.): The biggest opportunity for our ASCs in 2026 is not further cost cutting, but improving throughput and reliability. Optimizing block utilization, aligning anesthesia coverage with demand, reducing late starts and using data to manage access more proactively allow ASCs to spread fixed costs across more cases while improving efficiency and maintaining quality.
Matt Cavanagh. Principal at CliftonLarsonAllen (Maumee, Ohio): Some of the smartest moves an ASC can make in 2026 is to aggressively address their case mix and supply strategy. Standardizing implants and preference cards, tightening case‑costing, and steering surgeons toward higher‑value procedures lets centers grow margin without growing overhead. In a year where every dollar counts, disciplined case mix management is a lever ASCs have to stay ahead of rising costs.
Andrew Lovewell. CEO of Columbia (Mo.) Orthopaedic Group: The single most impactful thing ASCs can do to get ahead of rising operational costs in 2026 is to take control of their supply chain through leveraging their data and relationships.
Implants, disposables and pharmaceuticals are the fastest-rising expense lines in ASCs. Centers that leverage their relationships with their physicians and create standardization, narrow vendor variation, and actively use case-level cost data to negotiate pricing will materially outperform those that don’t. This isn’t just about getting a better price, it’s about eliminating variation and extra resources required to manage that variation.
ASCs that pair supply chain discipline with physician alignment and real-time cost transparency will be far better positioned to absorb inflation and reimbursement pressures. Additionally, ASCs must be communicating with the payers on a consistent basis about the rising costs so they attempt to recoup some of the costs through reimbursement negotiations.
Thomas Jeneby, MD. Plastic Surgeon in San Antonio: First, find some vendors “off the beaten path” that can cut prices better than larger vendors. We source our [Jackson-Pratt drains] and some sutures from smaller vendors at great savings. The customer service is better as well.
Allison Stock. COO of Surgical Management Professionals (Sioux Falls, S.D.): Get really clear on where the money is actually going—and manage it intentionally. ASCs that understand their costs at the case and service-line level can make smarter decisions around staffing, supplies, and scheduling before costs get out of hand. The biggest advantage right now isn’t cutting for the sake of cutting—it’s having visibility, staying disciplined, and being willing to adjust quickly as volumes, payers, and inflation shift.
