As ambulatory surgery centers (ASCs) enter the back half of 2025, operators are navigating a crosscurrent of forces.
On one side is a drive toward growth, whether that’s through new specialties, strategic partnerships or investment in technologies such as robotics and AI. On the other: a thicket of operational hurdles that continue to complicate ASCs’ best laid plans.
Earlier this year, Ambulatory Surgery Center News surveyed our audience on the biggest trends, challenges and opportunities shaping 2025. Now at the year’s midway point, ASC News is revisiting that survey to share previously unreported findings, with topics ranging from emerging operational challenges and market consolidation to service-line expansion and patient-volume projections.
Survey participants included a well-rounded ASC industry mix, with titles ranging from administrators and consultants to surgeons and C-suite leaders.
Geographically, responses also reflected a mix: 50% of centers were based in urban settings, while the remainder were evenly split between suburban and rural locations. Notably, 25% of respondents reported annual case volumes exceeding 10,000, providing perspective from some of the nation’s busiest surgery centers.
Operational challenges and planning for the future
When asked which operational challenges outside of reimbursement or staffing they see as most significant, ASC leaders pointed to a diverse set of concerns.
For instance, 31% of survey respondents said regulatory hurdles would have the biggest impact in 2025, tying with supply-chain disruptions as a top concern.
Others cited patient acquisition and scheduling inefficiencies as primary challenges.
What other operational challenges are most likely to impact your ASC in 2025 (choose the one you see as most significant)?
Despite these operational headwinds, most ASC operators don’t anticipate pulling back. In fact, many are betting on growth, both in their local markets and inside their own facilities.
More than 80% of the respondents who took part in the ASC News survey said they expect the number of ASCs in their region to increase this year. Roughly 1 in 5 reported plans to launch a new specialty in 2025, with spine, cardiovascular and total joint subspecialties cited as examples.
That outlook is helping to drive technology adoption as well.
While budget constraints persist in some centers, several respondents said they are making sizable investments in new platforms. Surgical robotics, telehealth and patient engagement tools each drew 25% of responses when operators were asked where they’re making their largest tech bets.
Other respondents cited AI and electronic health records as top priorities.
What, if any, new technologies are you implementing in your ASC in 2025 (if multiple apply, choose the answer that’s the greater investment)?
Staffing and partnerships
Technology is also playing a role in staffing strategies, which continue to evolve amid ongoing labor shortages.
About 81% of ASC leaders who took part in the ASC News survey said they’re addressing workforce gaps primarily by cross-training existing staff – far outpacing options like increased compensation or outsourcing.
Meanwhile, partnerships remain a key lever for operators looking to scale. Just over half of survey participants said they are exploring joint ventures or affiliations in 2025 to support growth.
That comes amid a broader expectation that case volumes will continue to rise: Nearly 9 in 10 respondents said they expect increased patient volume in 2025, while none forecasted a decline.
