You can often take the pulse of any industry by analyzing the words of its leaders.
And while there were plenty of interesting quotes from ambulatory surgery center (ASC) leaders in our reporting this year, a few stood out for their thoughtfulness, candor and relevance.
From pricing transparency and strategic partnerships, to navigating compliance and the growing shift towards high-acuity procedures, these quotes capture the essence of the challenges and opportunities facing ASCs today.
Below are 10 quotes that have defined the ASC landscape in 2024, resonating strongly with both the ASC News team and the broader surgery center community.
“A $3,000 procedure at my facility is a $30,000 procedure in Miami, Idaho or California.” | Dr. Keith Smith, co-founder of Surgery Center of Oklahoma (October 2024)
Smith has been a leading voice for transparency in ASC pricing, offering fixed, transparent rates at his facility since its inception. This stark price difference highlights the advantages of independent ASCs like the Surgery Center of Oklahoma, which offer competitive pricing without insurance contracts, Smith told ASC News.
His facility continues to attract out-of-state patients and employer groups – signaling an opportunity for other operators to cost-effective care in an increasingly expensive healthcare system.
Broadly, this concept of price transparency also reflects a larger trend shaping all of health care: consumerism and improving the end-user experience.
“Our business mandate is creating high-performing partnerships. All ASCs are effectively partnerships between health care systems, third parties like us, best-in-class managers, and surgeons.” | DJ Hill, CEO of Compass Surgical Partners (August 2024)
Hill’s vision for the future of ASCs relies heavily on partnerships as the foundation for success in the modern health care environment. This strategic approach to joint ventures and M&A has made Compass a key player in the ASC industry’s ongoing consolidation.
Of course, many of Compass Surgical’s peer ASC operating companies had active years as well, reflecting the growing trend of ASC JV activity.
“Acuity keeps improving in what we’re doing in the ASCs, and therefore, we’re beating our earnings expectations this year at USPI.” | Saum Sutaria, CEO of Tenet Healthcare (September 2024)
Tenet’s ambulatory surgery arm, United Surgical Partners International (USPI), has seen significant growth in 2024, driven by an increase in high-acuity procedures.
Sutaria’s focus on expanding these services has been central to Tenet’s strategic growth, with USPI now operating over 544 facilities. Tenet’s success reflects a broader industry trend: ASCs are increasingly performing complex surgeries, making them an increasingly critical component of the health care ecosystem.
Examples of this trend include the shift of cardiovascular procedures into surgery centers, along with complex spine procedures and others.
“We expect that march [toward higher-acuity procedures] to continue. It’s sometimes incremental; sometimes it has got big jumps like it did during COVID.” | Eric Evans, CEO of Surgery Partners (August 2024)
The ongoing shift toward performing higher-acuity surgeries in outpatient settings is the wind in Surgery Partner’s sails, Evans said during Surgery Partners’ Q2 2024 earnings call.
His comments reflect how advancements in surgical technology and an aging population have driven demand for ASC services, particularly in orthopedics. With significant growth in joint replacements and shoulder procedures, Evans projected that the ASC space will continue to capture more complex cases moving forward.
Surgery Partners is generally an ASC player to watch moving forward toward the end of 2024 and into 2025 beyond, too, as the company is rumored to be shopping itself for a potential sale.
“Go to every state in the union right now, and you’re going to see people, feel people, or hear people complaining about anesthesia.” | Dr. Arthur Valadie, Chief Physician for Coastal Orthopedics (August 2024)
The imbalance between supply and demand for anesthesia providers, exacerbated by the pandemic and retirements, has become a significant issue for surgery centers. As the demand for outpatient surgeries grows, finding sustainable solutions for anesthesia staffing is vital, Valadie told ASC News.
Several leaders identified the anesthesia challenge – unlikely to disappear in 2025 – as one of 2024’s biggest hurdles for ASC stakeholders.
“Maintaining adequate anesthesia coverage is one of the top challenges facing many ASCs,” Joan Dentler, founder of Avanza Healthcare Strategies, previously told ASC News.
“ASCs are seeing price increases in the overall cost of providing service through increased labor expenses (salaries, wages, staff benefits) and increased costs for goods and services (medical supplies, implants, utilities, rent, insurance). They are even seeing increased costs for subcontracted services like anesthesia care due to the relative shortage of providers, as reimbursement remains stagnant,” Michael McClain, founder and managing member of LeftCoast Healthcare Advisors, also said.
“Cardiology did a phenomenal job of gathering data to prove these procedures can be safely done in an ASC setting.” | Dr. Samuel Jones, Cardiologist, Chattanooga Heart Institute (July 2024)
It took meticulous data collection efforts by cardiologists to prove that cardiovascular procedures, once thought to require hospitalization, can be safely performed in ambulatory surgery centers.
This shift, supported by technological advancements and Centers for Medicare & Medicaid Services (CMS) payment updates, marks a critical transformation in cardiovascular care, bringing heart health services into the outpatient space and making ASCs a viable alternative to traditional hospitals, Jones told ASC News.
“ASCs are facing increasing pressure to ensure that the information they collect, store, and share is compliant with new regulations and patient expectations.” | Dr. Brian Curtis, Chief Compliance Officer, ASC Operations Group (July 2024)
Cyber-security threats defined health care as a whole in 2024, and the ASC space wasn’t immune to attacks.
Maintaining transparency without compromising privacy or efficiency in ambulatory surgery centers is a delicate balance.
As data-sharing requirements expand, including compliance with the 21st Century Cures Act, ASCs must stay ahead of changes while ensuring that patient data remains secure and accessible, Curtis told ASC News.
“One of the reasons we’ve launched this effort to align independent ASCs is that we see the opportunity to help those independent ASCs in their continuum – not only in helping them get started, but also in assisting those that are more mature move along their inevitable path.” | Woodrow Moore, founder of the Texas ASC Society and Ker Leader Medical (October 2024)
Moore’s remarks come at a time when many independent ASCs are weighing their options amidst rising consolidation. His organization, Ker Leader Medical, advocates for maintaining ownership control while improving operations.
“Many challenges revolve around managing teams. Retention is critical, and we’re focusing on creating a better workplace for our teammates. In health care, supply-demand imbalances are a concern, including in anesthesia. Additionally, we need to consider the impact of baby boomers and physicians retiring. These are challenges we and others in the industry are constantly thinking about.” | Keith Hennegan, chief operating officer for AMSURG (August 2024)
AMSURG is now an independent entity blazing its own trail – and the ASC company has big ambitions moving forward.
In addition to completing several deals in 2024, AMSURG also launched multiple de novo ASCs, with more coming, Hennegan told ASC News.
To execute on its growth vision, however, AMSURG leaders recognize the company will need to invest in its internal systems, processes and people. Hennegan emphasized that point during this interview.
“Compensation is always a major part of attracting new talent. However, the atmosphere, culture and overall benefits of having a strong organization that values its staff speaks volumes as well. Just like many ASCs, we cannot compete head to head with our local hospital in regards to wages. But, remaining relatively close, having a good benefits package, creating a strong working culture and showing how we value our staff helps eliminate a strictly dollars approach to our hiring process.” | Todd Currier, administrator of Bend Surgery Center (September 2024)
Related to investing in people, ASC News in September caught up with Currier, administrator of Bend Surgery Center, a 44,00-square-foot multi-specialty ASC with several operating rooms located in Bend, Oregon.
Bend Surgery Center has become known for its creative and committed approach to building an ASC culture of excellence. ASC News spoke with Currier at length about why investing in culture is so important, with insights that other ASCs around the country can take back to their own operations.
