Implants are among the costliest items in an ASC and can exceed a procedure’s total reimbursement, according to a December 2025 Advantien article. Some leaders say a key reason those costs are hard to cut is how surgeons come to trust a product in the first place.
“Supply cost is a big one. Implant costs are another big one,” Ray Brown, CEO of Lake Lucien Surgery Center in Maitland, Fla., told Becker’s. The center performs orthopedic, spine, pain management and cardiovascular procedures.
Surgeons often stay with “a rep who has done a good job on training them and getting them familiar with something,” he said, even when there may be “other options out there that are more cost effective.”
That loyalty is rooted in patient safety, Mr. Brown said. Surgeons “are really doing life or death,” he said, so once they are comfortable with an implant or technology, they are reluctant to change.
That comfort often comes from industry investment, he said. A rep may have spent hours in the OR with the physician, or the company may have trained the surgeon on cadavers. Switching products means rebuilding that confidence from scratch.
Physician-led alignment
Mr. Brown’s center is creating specialty chief medical officers to act as liaisons between administrators and surgeons. The CMOs identify and listen to the surgeons who aren’t on board and consider their rationale.
“We just want to hear it and see what we need to do,” he said.
When training is the barrier, he plans to bring manufacturers into the solution and ask them to “pony up and train.”
ASC leaders at Becker’s 32nd Annual: The Business and Operations of ASCs, held Oct. 29-31 in Chicago, described similar physician-first approaches.
Summit Orthopedics CEO Adam Berry said his group laid out every tray from every vendor in a conference room so surgeons could see how much the back-of-house staff had to manage. The surgeons chose to standardize to one vendor for hips and knees. The group reached 97% standardization and saw 20% to 25% savings in two separate contract rounds.
The surgeons were “the drivers and the pushers,” Mr. Berry said. “It was not the administrative team.”
Surgeons may be more open to switching than many administrators assume. Allen Passerallo, senior vice president of physician preference items at Vizient, cited a Vizient survey finding that 60% of surgeons would switch implants for savings of 15% or more. Vizient has said its orthopedic contracting program, which pools ASC purchasing, has delivered 22% to 55% savings on hip and knee implants through supplier standardization.
Jamey Pippert, director of ambulatory surgery centers at Houston-based Kelsey-Seybold Clinic, said her team works through implant choices directly with surgeons. Sometimes a center takes a loss on a case to keep a high-volume surgeon’s business.
“This guy brings us a lot of cases and we want him to continue to bring his cases. So we’ll take the hit on this one,” she said.
Industry as a training partner
Several leaders described reps as essential partners, especially in newer outpatient service lines.
Dale Yoo, MD, a cardiac electrophysiologist at Dallas-based Heart Rhythm Specialists, said he relies “heavily on industry to also provide education at their expense” as complex cardiology cases move to ASCs. “It is like learning another language,” he said.
Brenna Couch, purchasing and operations manager at Surgery Center of Athens in Georgia, said strong rep relationships pay off during supply disruptions. On the day of her panel, a rep drove two hours to deliver a delayed product.
“I tell my vendors that I need a partner in my business,” she said.
Mr. Brown said the path forward is collaboration among administrators, physicians and manufacturers, grounded in data. ASCs without case costing or an EHR risk falling behind, he said.
“No money, no mission,” he 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.
