
The number of ambulatory surgery centers (ASCs) in the United States has grown significantly over the past five years.
The ASC industry experienced an average annual growth rate of 5% between 2018 and 2023, according to industry analysts at IBIS World. This growth is expected to continue at approximately 3% from 2024 to 2033.
California is reported to have the highest number of ASCs. One of the biggest players in the market is Sutter Health.
Sutter Health, a not-for-profit integrated health care system based in Sacramento, serves over 3.5 million patients in California. It has over 15,000 nurses, 12,000 physicians, 2,000 advanced practice clinicians and 51,000 total employees.
The foundation of Sutter Health began taking shape as early as the 1800s, with independent hospitals opening to meet the health care needs of local Northern California communities. In January 1996, Sutter Health was created through the merger of the Sacramento-based Sutter Health and the Bay area-based California Healthcare System.
In 2006, Sutter Health’s Surgery Center Division started developing and managing ASCs. The division’s business development, clinical and operations teams now manage 37 ASCs throughout California – with plans to further expand to meet growing patient demand.
In January of this year, the Centers for Medicare & Medicaid Services (CMS) approved Sutter patients aged 65 and older to undergo total shoulder and ankle replacement surgeries and other procedures.
Sutter Surgery Center Division Chief Medical Officer Dr. Peter Bravos recently highlighted plans to use technology to help grow the ASCs in caring for these and all other patients.
“Robotic and artificial intelligence-aided tools can offer many benefits to patients, including less pain and faster recovery time,” Bravos told ASC News. “Many of our ASCs use them for general, urologic, gynecologic and orthopedic surgeries, and some have begun using an AI-powered polyp detector to aid in endoscopic procedures.”
Spine procedures also represent a new frontier for ASCs, he noted.
“More and more complex procedures, formerly only performed in the hospital, are now being done in ASCs,” Bravos continued. “Spine cases are just one example.”
‘We’re feeling the pinch’
Growth has not been without its challenges for ASCs in the U.S. ASCs seek solutions to manage inventory, reduce waste, harness data, enhance workflows and attract proficient physicians.
“We’re feeling the pinch of the nationwide shortage of anesthesiology providers,” Bravos said. “We’re looking into different solutions to help meet patient demand.”
In 2023, the demand for anesthesiologists outpaced supply, with hospitals and ASCs across the country facing significant shortages. Nearly 30% of anesthesiologists are expected to leave the profession by 2033, which could lead to a shortage of 12,500 anesthesiologists, according to a whitepaper from Medicus Healthcare Solutions.
The shortage has had an impact on providers, making it difficult to find coverage, especially coverage that fits the priorities and workflow of ASCs.
Even with industry challenges, Sutter forges ahead. Over the next five years, Sutter Health will expand access to care by opening 25 new ASCs and reconfiguring existing hospital campuses and care centers to meet community needs.
“Sutter is committed to addressing the health care access challenges facing patients in California,” Sutter Surgery Center Division CEO Brad Heaton said in an interview with ASC News. “We’re investing significantly in new and enhanced care facilities and services across all areas, including ambulatory surgery.”
In recognition of these enhancements, U.S. News & World Report has recognized 12 Sutter ASCs in its 2024-2025 Best Ambulatory Surgery Centers issue.
U.S. News rated nearly 5,000 surgery centers on various criteria, including their success in avoiding complications, ER visits, unplanned hospitalizations, patient outcomes, risk adjustment and more. The ASCs were evaluated in four specialty areas: colonoscopy/endoscopy, ophthalmology, orthopedics/spine and urology.
Bravos expressed his pride in the staff at Sutter ASCs.
“Every day, physicians, care teams and support staff at Sutter ASCs dedicate themselves to delivering safe, equitable, high-quality care to patients and their families across Northern California,” he said. “Recognition like this speaks to their commitment to excellence.”
U.S. News awards the designation of “Best Ambulatory Surgery Centers” only to those surgical centers that satisfy U.S. News’ statistical performance assessment. The highest-rated surgery centers earned a “best” rating.