ASC growth is heating up nationwide, but states in the South are expanding their ASC markets at an even more rapid pace.
Florida, for example, has become a proving ground for ASC growth, with multiple new centers opening last year through partnerships between health systems and physician groups in Panama City, Brandon, Daytona Beach, St. Johns and Jacksonville Beach.
Academic health centers in the region have also begun investing more heavily in ASCs. In 2024, Becker’s reported on 12 academic centers building out their ASC networks — seven of which were in the South.
Bernadette Purser, senior administrator at VCU Health in Richmond, Va., told Becker’s that ASCs are an important tool in expanding patients’ access to surgical services in the region.
“We continue to grow, expand and invest in our ASCs in order to meet our patients where they are,” she said. “For example, we recently broke ground on a new ASC/medical office building being built in Chesterfield, Va., which includes four operating rooms and two procedure rooms. It’ll be multispecialty and include endoscopy. This follows a similar center that we opened in Henrico, Va. Both of these are designed to reach our patients in the communities they live and create more access to our high-quality care.”
Policy shifts are also shaping ASC growth in southern states. In the last several years numerous southern states have either repealed, adjusted or plan to alter their certificate-of-need laws. Opponents of the laws argue that they stifle competition, while advocates claim they prevent unnecessary repetition of services.
In 2024, Georgia advanced CON reforms that exempt certain single-specialty ASCs from review if they are owned by a single physician or practice and stay below specified capital expenditure and operating room thresholds.
The reforms also allow non-owner physicians within the same specialty to practice in these centers and permit joint ventures with hospitals, including external management arrangements. The Georgia Department of Community Health is expected to issue additional recommendations that could lead to further policy changes. Since Oct. 10, Becker’s has reported on four new ASCs in Georgia alone.
North Carolina is on track for a near-total repeal of its CON laws by January 2026.As an interim measure, since Nov. 1, 2023, ASCs in counties with populations over 125,000 have been exempt from CON approval, already spurring new facility development in high-demand regions. North Carolina has already announced more than eight new ASCs in 2025, tying it with California for the most so far. With certificate-of-need restrictions set to ease later this year, the state is positioned for even faster growth.
