For ASC owners, many of whom run their practices as small businesses, a new ranking of the best U.S. states for business owners offers a useful benchmark for where the economic, regulatory and workforce environment is most favorable. Washington took the top spot in the 2026 ranking.
Researchers from Bridge Point Business Brokers compared all 50 states across 25 measures spanning the economy, infrastructure, workforce, innovation, business costs and taxes, according to the study.
Washington scored 66.65 out of 100, driven by the country’s highest rate of new business applications, a large STEM workforce and zero state income tax. Massachusetts ranked second at 62.53, followed by California at 58.79, Virginia at 58.43 and Utah at 58.20 to round out the top five.
Massachusetts’ ranking was driven by innovation and education, with nearly 48% of its workforce college-educated and the highest rate of patents per capita in the study. California placed third despite a 13.3% income tax rate and a net loss of more than 56,000 college-educated workers, buoyed by 57 major corporate headquarters and nearly $2 trillion in goods produced. Utah posted the fastest GDP growth rate in the study, at 7%.
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.
