Image by freestocks-photos from PixabaySince the start of 2025, Ambulatory Surgery Center News has spoken with ASC leaders, investors, advisors and other health care executives about everything from robotics and new technologies, to payer pressures and Medicaid cuts.
With the year officially at its midway point on July 2, ASC News wanted to take stock of those conversations and explore some of the comments that have best captured 2025’s first half.
Here’s what key ASC voices have said about the year thus far, with context on why their words matter as the industry prepares for the back half of 2025.
“Just because you designed it and opened four walls, it doesn’t necessarily mean everybody’s coming.” – Lanie Dschaak, director of ambulatory surgery operations at Harborview Medical Center
Dschaak spoke during an ASC News webinar about how her team is planning a new ASC with input from physicians and staff.
This quote gets at something a lot of ASC operators are figuring out the hard way: It’s not enough to build a shiny new facility and expect surgeons and patients to show up. Success depends on getting the details right, whether that is through block scheduling, workflow, staffing or surgeon buy-in. Especially now, centers need a clear purpose and plan before pouring the concrete.
“Facilities management has been a learning opportunity. Understanding ASC requirements in advance is vital because they significantly impact project timelines and finances.” – Crystal Aigner, administrator of Surgical Suites of Coastal Virginia and Port Warwick Surgery Center
This quote captures one of the biggest blind spots in HOPD-to-ASC conversions – a trend that has picked up steam in 2025.
Hospital systems often assume they already know what it takes to run a surgery center, but the facility requirements are completely different. Things like firewall separation, emergency protocols and generator testing can derail a timeline if not accounted for early.
As more systems look to convert space in response to reimbursement pressure and payer site-of-service shifts, this kind of operational due diligence is becoming essential.
“Denied claims are not so much a back-office headache. It’s really a sign of something off in your revenue cycle.” – Patricia Smith, director at SYNERGEN Health
This quote sums up the shift in how smart ASC operators are thinking about denials and revenue cycle management.
Denials are no longer just a billing issue; they’re a warning sign that something deeper in the revenue cycle isn’t working.
And as payers deploy AI to deny claims faster and rules change without notice, denial management has become a strategic necessity. Smith’s perspective reflects a larger trend: ASCs that treat denials as financial metrics – and respond with data, automation and team accountability – are the ones staying afloat in a tougher reimbursement landscape.
“We don’t have as much exposure to Medicaid in our ambulatory setting. While exchanges are relevant, they’re less impactful than the hospital segment.” – Saum Sutaria, CEO of Tenet Healthcare Corp. (NYSE: THC)
Sutaria’s remarks came during the company’s Q1 2025 earnings call, referring to his company’s ambulatory platform, United Surgical Partners International (USPI).
This quote is reflective of why some of the industry’s largest ASC operators say they feel relatively insulated from proposed Medicaid cuts. While hospitals brace for potential revenue loss, companies like Tenet have structured their ASC businesses to rely less on Medicaid and more on commercial and acute care cases.
That insulation is part of a larger trend where ASC growth is increasingly concentrated in higher-acuity, higher-margin procedures, often in markets and specialties where Medicaid plays a minimal role.
Still, as the regulatory landscape continues to shift, even these operators are keeping an eye on what’s coming next.
“I would beg to differ with him in regard to his recent post referencing AI replacing surgeons in the next five years,” – Wes Battiste, CEO and founder of Destin Surgery Center; advisor, Avanza Healthcare
Here, Battiste was responding to Elon Musk’s social media claim that AI-powered robots would soon outperform human surgeons.
While robotics and AI are increasingly used to support surgical procedures, ASC leaders like Battiste are skeptical about a near-future where machines fully replace surgeons. His comment reflects a broader industry view: AI can assist, but it can’t replicate the nuance, adaptability and judgment that real surgeons bring to the table. At least, not yet.
The conversation Musk sparked highlights how important it is for operators to balance innovation with caution as the tech evolves.
“I can only imagine that if a significant number of ASCs took advantage of similar loans, that recoupment will hit ASCs at a time when they are already reeling from rising labor and supply costs, stagnate reimbursement and ballooning anesthesia expenses. This won’t do anything to expand access to affordable care.” – Michael McClain, managing partner at LeftCoast Healthcare Advisors
McClain spoke to ASC News about the fallout from UnitedHealth Group’s stance that providers repay emergency loans issued after the 2024 Change Healthcare cyberattack.
Even as they still recovered from the Change Healthcare disruption, ASCs were being hit with loan recoupment demands, which put further strain on already tight margins. McClain’s comment ties into a broader concern in the ASC industry: that large-scale payer changes, especially when it’s sudden, can destabilize small, independent providers the most.
“A lot of operators tell me they’re interested in robotics, but the economics just don’t work for them with the systems currently on the market.” – Greg Roche, CEO of Distalmotion
Even as the technology improves and patient and surgeon interest grows, cost remains a major roadblock to ASC robotics adoption.
Unless surgical robotics can fit within the tight financial model of an ASC, especially when it comes to volume and staffing, many operators will remain hesitant. For robotics companies trying to break into the outpatient space, that’s the challenge to solve.
Even so, many ASC leaders spoke to ASC News in 2025 about robotics being a tool for attracting and retaining physicians.
“By joining one of the nation’s most respected health systems, we are strengthening our ability to serve patients and communities, while continuing to elevate the outpatient surgical experience across the country.” – AMSURG CEO Jeff Snodgrass
Snodgrass’s quote highlights one of the defining ASC trends of 2025: the strengthening of ties between ASCs and large health systems.
With Ascension acquiring AMSURG — one of the largest ASC operators in the U.S. — this year’s biggest story is about consolidation and integration.
“Health systems are typically looking to have an ASC strategy, as I think we’ve all heard, because ASCs are really the future way to go, and health systems have to have a game plan if they expect to keep those patients in-network. … Once these cases start coming off [the inpatient list], they’re going to be pushed to the ASC, and it’s going to be really important to work out an ambulatory footprint and ambulatory strategy.” – Jessica Roberts-Becerra, co-founder and managing partner at Vertex Surgical Solutions
This quote from Roberts-Becerra – speaking at the ASC News Investment & Operations conference in February – clearly reflects the 2025 reality: ASCs are becoming the default setting for many surgical procedures.
The statement “ASCs are really the future way to go” aligns with a widespread consensus among providers, payers and investors that the shift to outpatient is permanent and accelerating.
And with more procedures coming off the inpatient-only list, the quote highlights how regulatory changes are driving clinical migration.
