North Carolina has had at least four ASCs announced or opened in the past 60 days, and two North Carolina ASC leaders spoke with Becker's ASC Review on the reasons behind the growth.
Cory Gruver, communications director for the North Carolina Ambulatory Surgical Center Association, attributes the growth to hospital partnerships, a trend happening nationally.
"The hospitals have probably been holding the operating room [certificates of need] and have decided to use them on freestanding centers rather than inpatient," he told Becker's ASC Review.
Much of North Carolina's ASC growth is in Raleigh. Raleigh Orthopaedic Clinic and UNC Rex Healthcare are planning a third ASC in Garner, N.C., and Raleigh Orthopaedic Surgery Center's outpatient total joint program grew by 40 percent in 2020.
Brian Bizub, CEO of Raleigh Orthopaedic Clinic, attributed much of the ASC growth with the coinciding population growth. Raleigh is the second fastest growing metro area in the U.S., and more than 70 people are moving into the city daily.
North Carolina is also one of top five states in terms of total new residents between 2019 and 2020, according to data from the U.S. census.
Raleigh is part of the state's "Research Triangle," Mr. Bizub noted, with access to prominent universities, colleges, research facilities and technology, making it prime for ASC growth.
Mr. Bizub cited CON laws as a barrier for some healthcare providers, which could be contributing to ASC partnerships.
"ASCs are busy and submit statistics quarterly that prove to the CON agency that ASC beds are needed. Many operating room procedures are being performed in a procedure room and are reported annually to the division of human resources, who determine the OR and ASC beds needed per county," he told Becker's ASC Review. "Raleigh is one of the few cities that I have lived in where hospitals are still applying for new hospital CONs and additional hospital beds."
There are currently four bills in the North Carolina state legislature to drastically change the CON laws. One specifically proposes changes to how ASCs are subject to CON review.