For ASCs, staffing costs are not just about how many employees are on the payroll — they are about matching that payroll to a case volume that can change quickly throughout the year.
Patrick McEneaney, DPM, owner and CEO of Crystal Lake-based Northern Illinois Foot & Ankle Specialists, sees that balancing act as one of the biggest financial pressures heading into 2027. Staff too heavily during a slower stretch and labor costs climb; cut hours too aggressively and centers risk losing employees they will need when volume picks back up.
Dr. McEneaney recently joined Becker’s to discuss how ASCs can get ahead of staffing pressure and what levers are most flexible for ASC leaders.
Editor’s note: This response has been edited for clarity and length.
Question: What’s the single biggest financial pressure on your ASC or practice heading into next year, and what’s one move you’re making now to get ahead of it?
Dr. McEneaney: The biggest financial pressure will continue to be staffing. Many ASCs have busy seasons and slower seasons. During busy seasons, many ASCs may feel understaffed due to high case volume. At times, like after the New Year, case volume can drop off quickly. Administrators may feel overstaffed until case volume increases again. Most staff will want consistent hours all year, which can lead to overstaffing during slower times. If you cut back hours too much, staff may leave for other opportunities where they can get the hours they are looking for. Staffing is always sensitive and costly if you lean toward either extreme.
Ways to manage this include:
1. [Temporary employees] can be used during really busy times. Even though temps are more expensive, they don’t require a year-round commitment.
2. Part-time employees whom you can flex for more hours during busy times
3. Re-evaluate the staffing needs. It is easy to staff based on what makes everyone comfortable, but you must always evaluate necessity. Can you cross train staff to perform other responsibilities?
4. Outsource physical staff with virtual staff or AI.
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.
