ASCs pride themselves on efficiency, but industry leaders say a surprising amount of margin is quietly slipping away in the form of wasted minutes, underutilized block time and idle operating rooms.
“A surprising amount of ASC margin is left on the table in the form of minutes,” Scott Kulstad, CEO of St. Paul, Minn.-based St. Paul Eye Clinic, told Becker’s.
Jacquie Mateja, BSN, RN, clinical director of Anchorage, Alaska-based Creekside Surgery Center, said underutilization of block time is one of the most common and most avoidable sources of lost opportunity she sees.
“Late releasing of blocks and generally unused blocks contributes to wasted hours within all areas of the center,” she said. “This can lead to staffing issues with the potential need for mandatory overstaffing due to low case volume.”
The downstream effects compound quickly. Fluctuating between too many and too few staff creates workforce instability, drives up labor costs and undermines the operational predictability that makes ASCs attractive to both surgeons and patients in the first place.
Ms. Mateja advises strict block release policies, open communication with surgeons and their teams about scheduling trends, and technology-assisted scheduling to fill gaps before they become losses.
“Integrating AI-assisted and data-driven scheduling is a way to decrease idle time and ensure that blocks are being filled,” she said.
Mr. Kulstad framed the issue in starker terms.
“This is operational discipline as strategy,” he said. “The opportunity is to manage time like inventory: standard work, visible readiness metrics, surgeon-level feedback loops and clear rules for releasing and backfilling time without disrupting core schedules.”
On-time first cases, reliable room turnover and disciplined block utilization aren’t only quality-of-life improvements for staff and surgeons, but also margin drivers that compound over hundreds of cases a year.
Randy Robbins, MD, president of Addison, Texas-based Valiant Anesthesia Associates, pointed to a specific and often overlooked culprit — flip rooms sitting idle during long cases.
“One of the places that ASCs are leaving significant revenue on the table is utilizing flip rooms for cases that take 90-plus minutes,” he said. “If a room is sitting empty multiple times a day for over an hour, that room could be utilized to recruit new surgical volume or allow current providers to use the room more effectively.”
Dr. Robbins noted that while many surgeons now expect a second flip room, the lost revenue from mismanaging that time can be significant, and largely invisible if no one is actively tracking it.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.