Image by Andrew Khoroshavin from PixabayRising operational costs and staffing constraints are two of the most pressing challenges for ambulatory surgery centers (ASCs) in 2025, new survey findings from Ambulatory Surgery Center News suggest.
Other pain points include anesthesiology, reimbursement rates and market consolidation, according to the survey.
To better understand current trends and challenges in the ASC space, ASC News conducted a survey of professionals across a range of roles in the industry at the beginning of 2025. Respondents included ASC administrators, consultants, surgeons, C-suite executives and others, offering a well-rounded snapshot of perspectives from the field.
Participants represented a mix of geographic settings as well, with half operating in urban areas and the other half evenly split between rural and suburban markets. Notably, a quarter of respondents reported handling more than 10,000 cases annually, underscoring insights from some of the highest-volume centers in the country.
When it comes to rising operational costs, health care providers across the board – but especially ASCs – are struggling.
Physician practices’ operating expenses jumped nearly 9% in 2024, with median direct costs surpassing $1.1 million annually per physician, according to ambulatory-focused consulting firm Marisa Consulting. At the same time, inflation in health care, hit a 23-year high of 4.6%.
Employee salaries and wages make up a substantial portion of an ASC’s operating spend, with staff compensation steadily rising in recent years to battle burnout in health care. The cost of drugs and medical supplies is another major line item for ASCs, with costs for those operating essentials likewise climbing since the COVID-19 pandemic and sector-wide supply-chain hurdles.
Curtis K. Collins, COO of Palmetto Surgery Center, previously told ASC News that rising costs would be a major factor in 2025.
“The cost of supplies and capital equipment purchases continue to rise, with certain supplies out of stock or being limited,” Collins told ASC News in December. “Anticipate large capital expenses well in advance of equipment end-of-life, because manufacturer turn-around can be lengthy. We have experienced this over the last year with replacing sterilization equipment. We are still waiting on one large order that was placed over a year ago.”
Of those who participated in the ASC News survey, more than 31% identified rising operational costs as the single greatest challenge for ASC operators in 2025 – far more than any other option.
The challenge cited the second most frequent for ASCs in 2025: staffing constraints. Of those who completed the survey, 25% identified staffing constraints as the single greatest challenge for ASCs.
What do you see as the single greatest challenge for ASC operators in 2025?
Source: ASC News 2025 Industry Outlook survey.
Several ASC roles have regularly proven difficult to attract and retain due to workforce shortages, competition with hospitals and rising compensation demands.
ASCs looking for registered nurses (RNs) have to go head-to-head with hospitals that can offer higher salaries, sign-on bonuses or more robust benefits. Surgical technologists are also often in short supply, with many lured to larger health systems for all of the same reasons.
Generally, health care leadership roles are becoming more challenging to fill, too.
A separate survey from AMN Healthcare released on Monday highlighted how nearly half of surveyed hospital, medical group and other health care facility leaders plan to leave their organizations over the next 12 months.
Many ASC leaders anticipated staffing being a sore spot in 2025.
“The challenges – such as staffing shortages, reimbursement pressures and supply chain disruptions – will continue to test our operational resilience,” Geri Eaves, CEO and administrator of the Bone and Joint Institute of Tennessee Surgery Center, previously told ASC News “The tight labor market will demand competitive wages and improved work-life balance to attract and retain skilled staff.”
Just 12.5% of ASC News survey participants identified anesthesiology as the single greatest challenge for ASC operators in 2025, with the same percentage choosing market consolidation and reimbursement.
Of those who completed the survey, half said they worked for independent ASCs. The majority of respondents came from ASCs with more than three specialties.
