A shift toward value-based care, the ongoing consolidation of independent ASCs and an increasing role of AI are three things to look out for in 2025 in the ASC space.
These 10 surgeons, CEOs, CFOs and presidents recently connected with Becker's to give their ASC industry predictions for 2025.
Note: Responses were lightly edited for clarity and length.
Question: What are your predictions for the ASC industry in 2025?
Adam Bruggeman, MD. CEO and Spine Surgeon of Texas Spine Care Center (San Antonio): I think the change in administration in Washington, D.C., likely means a renewed focus on the inpatient only list as well as the ASC list. I anticipate we will see more cases eligible for the surgery center this year, and if not, then by 2026.
Ira Kornbluth, MD. President of Clearway Pain Solutions (Annapolis, Md.): ASCs are expected to capture a larger share of surgical volume due to lower costs for payors, physician preference and increased convenience for patients. Aging baby boomers and technological advancements will help accelerate the transformation to an outpatient service model.
Kyle Moyles, MD. Orthopedic Hand Surgeon of Melbourne (Fla.) Hand Center: With stagnant reimbursement and increasing costs, we will continue to see margin compression in the ASC space. This will likely slow development of new centers. Case volume will continue to increase at existing centers, as younger surgeons migrate their cases from the hospital to the ASC. I anticipate the increase in demand for ASC capacity coupled with reduced margins will make hospital joint ventures a more palatable option for many de novo projects. An interesting wildcard will be if Congress repeals the ban on physician-owned hospitals as is widely predicted, which would have a substantial effect on new ASC projects.
Mary O'Connor, MD. Co-founder, Chief Medical Officer and Chief Compliance Officer of Vori Health (Nashville, Tenn.): Preop optimization of patients with modifiable surgical risk factors will be increasingly important to expand the number of patients eligible for same-day surgery as chronic medical conditions increase in prevalence.
Chantell Preston. Founder and CEO of Preston Partners (Houston): In 2025, single-specialty ASCs will continue to dominate the market, leveraging their focused expertise in areas such as orthopedics, spine and cardiovascular. These facilities will prioritize patient-centered care, offering streamlined services and advanced technologies such as robotics, AI and advanced monitoring systems enhancing surgical precision and post-operative outcomes.
In regards to reimbursement, I predict that the industry will see a significant shift toward value-based care, with ASCs incentivized through bundled payments and quality-based reimbursement models to deliver superior outcomes at lower costs, solidifying their role as a cornerstone of modern healthcare delivery.
Kurt Sargent. CFO of Stevens Community Medical Center (Morris, Minn.): I work in the critical access hospital world, but it is likely the same in every healthcare market. I think three things that are all related to insurance:
No. 1 is the administrative burden required by the medical insurance industry will continue to increase the administrative cost on providers;
No. 2 is the role of artificial intelligence in the decision making process by the insurers; and
No. 3 is that the insurance companies, and especially Medicare Advantage plans, will continue to identify ways to not pay for services whether by denying to pre-authorize services, not pay based on a minor technicality or through rescission, which is pre-authorizing a service then going back to deny the claim and taking back their money after the fact. The latter is often done months or even years later. This leaves us with no recourse to collect and we do not have the resources to fight these efforts employed by the insurance industry.
Larry Sobal. CEO of Heart and Vascular Institute of Wisconsin (Appleton): To quote Charles Dickens, "It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness." What I mean is that 2025 will be a year of great uncertainty with the possible outcomes for ASCs ranging from very positive to very negative. The reason for this is that the new presidential administration, and whoever achieves approval for his cabinet and other key appointees particularly for HHS and CMS, may drive very favorable policies that incorporate site neutrality, accelerate approval of additional ASC procedures, reduced regulatory burdens, etc.
On the other hand, rising operating costs, staffing issues, insurance barriers, high interest rates and other challenges may continue to stress the viability of sustaining and developing ASCs. For most of my career I would be inclined to say that the reality will settle somewhere in the middle but an increased outcry for disrupting the status quo in healthcare leads me to believe that 2025 will err on a more positive trajectory with continued volume moving to an ASC environment.
Sami Spencer. CEO of Missoula (Mont.) Bone & Joint Surgery Center: I see the position ASCs will be in for 2025 is that the reimbursement disparity and double-digit cost increases will continue to be a big challenge. Staff costs and recruitment challenges will most likely continue to be a problem for surgery centers as well. The new issue many ASCs have faced recently or will face in 2025 is the anesthesiologist shortage and anesthesia groups demanding stipends to offset their losses. This poses financial challenges and requires a deep look at bringing anesthesia services in-house, improving efficiencies and service lines, along with analyzing payer mixes since the Medicare population is increasing every day.
Adam Spiegel. CEO of NorthStar Anesthesia (Irving, Texas): ASCs will face at least two challenges in 2025. First, ASCs will continue to see a disproportionate share of volume growth as they can increasingly safely handle more types of cases. This will lead to a need for continued expansion of access to patients. Second, the lack of anesthesia providers for ASCs in many markets will continue, and anesthesia compensation will continue to rise. These two dynamics are at odds: fewer providers and more access needed. This means ASCs will have to start paying subsidies for anesthesia, if they aren’t already, while experiencing no relief from pressures to recruit and retain top talent.
To address this, in 2025, ASC leaders will need to find creative staffing solutions that ensure the appropriate level of care while balancing rising costs and expect their staffing partners to offer greater transparency on cost and revenue.
Jordan Taradash. CEO of PeopleOne Health (Pittsburgh): Two main opportunities are set to evolve further in 2025. First, there will be ongoing consolidation of independent ASCs into larger health systems, insurance companies and payviders, mirroring the integration of primary care and specialty practices over the past 20 years. Second, independent ASCs will increasingly align with value-based health plans, aggregated by independent third-party administrators and through direct contracts with self-funded employers. In 2025, we will continue to see the dynamic tension between established industry players and value-based disruptors unfold at the front lines.