Here are three states that are primed for or experiencing ASC booms:
Tennessee
In May, Tennessee Gov. Bill Lee signed legislation that modifies the state's certificate-of-need requirements. Beginning Dec. 31, 2027, ASCs will no longer be required to obtain a certificate, with additional regulatory requirements.
Sam Sarbacker, vice president of development at real estate developer Oman Gibson, told Becker's that ASC development will soar in Tennessee when the requirement is eliminated.
South Carolina
South Carolina is another state primed for an ASC boom. In October, South Carolina repealed the state's certificate of need law, which has been on the books since the 1970s .South Carolina Governor Henry McMaster said that patients would benefit from the repeal "when the proven power of the free market is unleashed in our state."
The state is also seeing the highest population growth — the population grew the equivalent of 1.15% per year between 2008 and 2023, according to data from Pew.
Earlier this year, Bon Secours Mercy Health and Compass Surgical Partners' joint venture surgery center opened in April in Greenville.
North Carolina
North Carolina, another state seeing high population growth, was named one of the best places to start a business in 2024 by CNBC.
In 2023, the state signed legislation exempting "qualified urban ambulatory surgical facilities” from CON review, among other changes. Additionally, the North Carolina Senate proposed its budget for the next two fiscal years that would drop CON requirements in urban areas on the condition that those ASCs meet the Medicaid and self-pay threshold.
Mr. Sarbacker told Becker's North Carolina is also on the radar as primed for an ASC boom as the CON law is in flux.