Ambulatory surgery center (ASC) operators face a rapidly evolving health care landscape, requiring strategic planning to thrive.
During a recent panel discussion at an industry conference, ASC leaders shared their expertise on strategies for revenue growth and operational efficiency.
If operators can understand and anticipate changing demographics and market conditions, they can turn challenges into opportunities, Patrick Garman, president of Spartan Health Surgicenter, said during the panel.
“The aging population and industrial factors shape medical needs,” he said. “This is a prime time for entrepreneurial physicians, especially orthopedic surgeons, to migrate to the ASC setting.”
Pennsylvania-based Spartan is navigating a joint venture model and tackling staffing shortages, particularly in anesthesia.
“The Pittsburgh market is challenging for anesthesia staffing,” he said. “We’re also negotiating insurance contracts to secure carve-outs for orthopedic and podiatry implants.”
Staffing is not just a foundational component but the key determinant of an ASC’s operational efficiency, patient satisfaction and financial health, Fawn Esser-Lipp, executive director of The Surgery Center LLC, added.
“Staffing is the most basic, yet the most critical, factor for revenue growth,” she said.
Achieving ‘staffing excellence’
Staffing excellence begins with selecting the right personnel for revenue cycle management (RCM) and billing departments, Esser-Lipp said. These roles directly impact an ASC’s ability to collect payments efficiently, reduce denials and optimize cash flow.
“Whether you’re outsourcing RCM or managing it in-house, having a knowledgeable and well-trained team is key,” she said.
Delays or errors in billing can ripple through an ASC’s financial operations, making skilled staff indispensable.
The clinical team is equally critical, she added. Proper staffing ensures high-quality patient care, efficient case turnover and adherence to safety protocols. In a fast-paced environment, maintaining adequate nurse-to-patient ratios and recruiting experienced surgical staff can mean the difference between success and inefficiency.
“You can’t underestimate the impact of staff engagement on patient outcomes and satisfaction,” Esser-Lipp said. “A cohesive, motivated team enhances the overall patient experience, which, in turn, drives referrals and repeat business.”
In competitive health care markets dominated by large health systems, staffing becomes even more challenging. Wisconsin-based The Surgery Center LLC is surrounded by three major health systems.
“Recruiting physicians and staff is not as simple as it sounds in a market like ours,” Esser-Lipp said. With significant competition for talent, her ASC has focused on retaining current staff and optimizing existing resources. This involves cross-training team members and implementing efficient workflows to maximize productivity without overburdening employees.
Staffing strategy is tied to patient satisfaction and retention, she added.
“If you can’t grow your volume through new service lines or physician recruitment, maintaining what you have becomes critical,” Esser-Lipp said.
Her team focuses on delivering consistent, top-notch care so that patients are likely to refer family and friends to the center.
Capitalizing on opportunities
Joseph D’Agostino, administrator at Advanced Surgery Center Perimeter, said his facility capitalized on a local competitor’s closure by scaling up pediatric ENT services.
“We aligned our partnerships and cultivated specialized staff, turning a challenge into a major growth opportunity,” he said.
When the competing ASC announced its closure, D’Agostino and his team recognized the immediate opportunity to fill the service gap left behind. This competitor had a strong foothold in pediatric ENT, particularly serving a niche patient population that required specialized care.
“We knew there was ample surgical business to capture,” he said. “It was a rare chance to not only grow our case volume but also diversify our service offerings in a meaningful way.”
D’Agostino credited his team’s swift response to this shift in the local competitive landscape. By closely monitoring market changes and maintaining strong relationships with surgeons, his ASC was able to move quickly to secure new partnerships and develop the necessary infrastructure.
“We made sure to partner with surgeons to understand the challenges they faced in their practices,” he said. “This included streamlining communication, accommodating their schedules, and ensuring that we had the right equipment and support staff in place.”
Pediatric ENT now accounts for 70% of the ASC’s case mix, transforming what could have been a regional challenge into a significant driver of revenue growth.
“This wasn’t just about increasing volume, it was about filling a critical need in the community,” he said.
