The prospect of opening a standalone ASC in 2025 is marked by both challenges and opportunities as the demand for surgical services, as well as operational costs, both remain high.
Geoffrey Hibbert, BSN, RN, is an administrator at Trinity Surgery Center Greenville, S.C., which is currently under construction. When completed, the independent, physician-owned ASC will offer ophthalmology, ENT, orthopedic and hand procedures, and will operate in connection with an existing physician practice within the facility.
Mr. Hibbert has years of experience working on the opening teams of both hospitals and surgery centers, but said that when it comes to new construction, even seasoned leaders should expect the unexpected.
“There’s just always a little something,” he said. “For example, they were supposed to be airlifting in our sterilizers that we ordered — they put them on a boat.”
Other mundane yet unexpected delays, like getting electricity fully set up, can add up once you begin factoring in timely processes like accreditation, state health department approvals and other regulatory processes.
Staffing, however, can be a major challenge for new standalone centers.
“The tough part when you’re opening up a new building is to bring in staff,” Mr. Hibbert said. “We’re also going to have an EMR that needs to be learned, and that’s not something you do overnight.
When asked what operational hurdles they were most heavily anticipating in 2026, 72% of ASC leaders told VMG Health that expenses related to operations, supplies and wages was their chief concern.
Supply costs can also be an especially challenging area for independent ASCs, who lack hospital and health systems’ access to shared resources.
“[W]hen you’re part of the big system, you have that buying power,” Mr. Hibbert said. “Some of that is mitigated by getting a [group purchasing organization],” as his ASC is doing.
Surviving and ultimately becoming profitable as an independent ASC hinges heavily on reputation, word-of-mouth referrals and being connected with the surrounding community — especially in smaller towns, rural regions or states with highly competitive markets, like that of the Greenville area.
Earlier this year, Winston-Salem, N.C.-based Novant Health entered the South Carolina market with a $2.4 million acquisition of three hospitals and their affiliated physician clinics, heating up the competition within the state.
“These are small towns, small areas, so people know you,” Mr. Hibbert said. Having built trusting and lasting relationships at his previous employers in the area, Trinity Surgery Center is more well connected to an existing referral base.
“I think the only way it really works is if you have an established group in the area that has a very good name for themselves and it’s pretty much word-of-mouth,” Mr. Hibbert added. “Everybody knows that they’re the best eye doctors in the area. They’re very Christian-focused with preparing their patients for surgery. In the South, that goes a long way.”
