Despite ongoing challenges, ambulatory surgery center (ASC) leaders remain hopeful about financial performance in 2025.
In fact, 88% of ASC operators surveyed by health care consulting and business performance firm VMG Health expect their financial performance to be similar to or better than in 2024.
Sentiment about the market is positive, according to the survey. Among respondents, 42% anticipate a positive change in EBITDA, while 46% expect stability. Still, a significant challenge for ASCs in 2025 is expected to be attracting and retaining physicians, particularly surgeons. The survey shows that 72% of respondents may add new surgeons in 2025.
Despite the generally upbeat findings in the survey, labor shortages and supply chain issues may be challenges in the new year. Sixty-nine percent of respondents identify supply chain challenges and wage inflation as top operational concerns, and 47% anticipate continued struggles with labor shortages and contract labor costs.
The survey indicates a divide between independently owned ASCs and those backed by corporate or health system partnerships in terms of transaction activity. Eighty-four percent of independently owned ASCs do not anticipate any sale activity in 2025, while 90% of corporate- and private equity-backed ASCs foresee continued or increased transaction activity.
But in 2025, many ASCs may consider strategic partnerships rather than outright sales. Fifty-six percent of independent ASCs express interest in partnerships, particularly with health systems, which were the preferred partner for 57% of respondents.
Cost inflation remains a pressing issue, especially concerning supplies and anesthesia. Sixty-nine percent of ASC leaders cite expense inflation as a primary operational challenge, while 54% are particularly concerned with anesthesia costs.
“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 with Coastal Orthopedics, previously told ASC News.
Lastly, many ASCs plan to grow by diversifying their service lines. Forty-four percent of respondents are exploring total joint procedures, 53% are considering spine surgery, and 38% are interested in expanding into cardiology.
The survey findings echo the sentiments that ASC leaders have expressed recently in earnings calls.
One example is Tenet Healthcare (NYSE: THC), whose ASC arm United Surgical Partners International (USPI) has ownership interests in 520 ASCs in 37 states.
“… The market has been expanding for these services when you can offer it in an ambulatory setting,” Tenet CEO Saum Sutaria said during a recent earnings call. “And so we’re focused on that more than anything else – continuing to expand the marketplace.”
And with the ongoing shortage of specialists and increased competition from other healthcare providers, ASC operators also have commented on the need to implement strategies to attract talent, such as competitive compensation packages and flexible scheduling. And legislative changes may help, too.
Recently, the Medicare Patient Access and Practice Stabilization Act was introduced by Congressman Greg Murphy, M.D. The bill seeks to address the ongoing Medicare reimbursement challenges that threaten the financial stability of physician practices.
The legislation, which has bipartisan support and endorsements from major medical associations like the Ambulatory Surgery Center Association (ASCA), American Medical Association, and American Academy of Ophthalmology, aims to counteract the proposed 2.8% Medicare reimbursement rate cut scheduled for January 2025.
