The ASC industry is rapidly expanding throughout the U.S. as developers and ASC operators race to meet the growing demand for surgical services.
When it comes to de novo ASCs, the market is being reshaped by a range of factors, from population shifts to new ideas in patient-centered design.
Here are eight things steering ASC de novo development in 2026:
1. ASCs are commanding the highest rent increases of any outpatient facility type, with rents climbing more than 8% even as leases surged 145% between 2022 and 2025, according to a March 26 report from real estate company CBRE, a sign of persistent demand for standalone outpatient facilities.
2. Heightened demand for medical outpatient facilities has been documented particularly in the Sun Belt, real estate services firm JLL said in its 2026 Medical Outpatient Building Perspective report released March 24. But current development trends are pacing behind demand, with about 93% of current MOB space nationwide currently occupied.
3. The mismatch of outpatient supply and demand was most notable in cities in Florida and Texas. Orlando, for example, is projected to see a 16.4% increase in outpatient visits through 2029, but construction of the necessary sites is projected to grow by only 3.8%.
4. Dallas-Forth Worth, Houston, San Antonio, Atlanta, Phoenix, Washington D.C. and Boston were all metropolitan areas identified in the report as having significant gaps between their outpatient visit and construction growth.
5. New York City—specifically Manhattan—was the only area identified in which construction growth outpaced outpatient visit growth, at 9.6% 8.4%, respectively.
6. Given the specialized nature of ASCs, their design and infrastructure must be carefully planned and executed to balance equipment and technology needs, efficiency and patient experience.
7. An April 21 report published by Bham Now, highlights the approach of one architecture firm in Birmingham, Ala., in its design of Birmingham Heart & Vascular Surgery Center, a joint venture between Birmingham Heart Clinic, UAB MEdicine and US Heart & Vascular.
“What initially drew us to Birchfield Penuel Architects was their strong reputation for healthcare design and their ability to balance clinical efficiency with a patient-centered approach,” Ryan McClanahan, regional president of US Heart & Vascular, said in the report. “They demonstrated a clear understanding of the complexities involved in ASCs, particularly cardiovascular environments where precision and workflow are critical.”
8. While operating room quantity is the anchoring factor in ASC design, streamlined patient experience and throughput as well as staff satisfaction are also essential considerations in ASC architecture. Stacy Williams, senior associate of BPA said in the report that they worked carefully to create a calm and supportive environment for patients, which meant maximizing natural light in patient and staff areas.
“As a result, nearly every patient bay has access to daylight, which helps reduce patient stress and improves the working environment for staff,” Ms. Williams said.
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.