Where ASC Leaders Plan to Invest in 2026

Already looking ahead to 2026, ambulatory surgery center (ASC) leaders are making plans for where they’ll put their dollars to work.

Outpatient demand continues to climb, and with the U.S. Centers for Medicare & Medicaid Services (CMS) steadily opening the door to more procedures in the ASC setting, operators are thinking carefully about how to match that growth with the right investments.

To get a better sense of what’s on the radar of surgery centers, ASC News asked operators to pull back the curtain on their decision-making process: Will they be adding service lines next year? Investing in new technology? Considering a facility expansion?

The answers show a sector preparing to widen its reach. Cardiovascular and orthopedic cases are expected to see the most attention in terms of specialty investments, with payers and patient preference driving cases out of hospitals.

Robotics, AI and patient-engagement tools are part of the 2026-investments conversation, though most leaders say they’re not chasing technology for its own sake. And when it comes to bricks and mortar, the theme is flexibility. Operators are building facilities that can scale up as volumes increase.

Here’s what seven executives told ASC News about how they’re planning to direct their capital in the year ahead. The following responses have been edited for style, length and clarity.

Brandon Hollis

Hollis is the vice president of operations at AMSURG, an ASC management company with a network of more than 250 centers across the U.S. Ascension is currently in the process of acquiring AMSURG.

In 2026, AMSURG will be focused on strategic investments that support facility and service line expansion, driven by increased demand for outpatient surgical care. Regulatory updates, such as the addition of CPT codes to the ASC Covered Procedures List and the removal of inpatient-only (IPO) codes, are enabling a broader range of procedures to be performed in the ASC setting. These changes allow us to scale responsibly while maintaining our commitment to clinical excellence and delivering a superb patient experience. 

We’re also following the lead of our physician partners, whose insights help guide our capital planning to ensure alignment with evolving patient and provider needs. The ASC industry continues to be a bright spot in health care, offering high-quality, cost-effective care in a setting that prioritizes both outcomes and patient satisfaction.

Chris Fromme

Fromme is the newly appointed COO at Compass Surgical Partners, which develops and manages a vast network of ASCs across numerous specialties, from cardiovascular and spine to orthopedics to pain management.  

At Compass, we evaluate adding new service lines to our service areas based on whether they expand access to high-quality ambulatory surgical care in the geographic area, and whether the addition creates value for our physician and health system partners and our patients.

Two service lines that stand out among our efforts currently:

– Cardiovascular: We are currently developing de novo CV ASCs in the Dallas and Richmond areas. We anticipate adding more CV ASCs to our portfolio in the future.

– Total Joint and Spine: Private payers, as well as physician and patient preferences, have been driving total joint and spine cases to ASCs. CMS’ proposal to remove 285 musculoskeletal codes from the Inpatient Only list would accelerate case migration. Compass announced the opening of NYC Joint & Spine Center earlier this year. Stay tuned for announcements about the development of additional orthopedic ASCs that perform total joint replacements and spine surgeries.

We don’t chase technology for its own sake; we invest where it directly improves care quality, operational efficiency, or the patient experience. Our focus is on technology that simplifies operations and supports physicians in delivering excellent outcomes.

For example, Stacy Danahy, VP of orthopedic/spine strategy, has led the adoption of STREAMD at several centers. The program supplements and enhances the personalized coaching that surgeons and ASC staff provide for patients before and after their procedures. Patients receive text messages containing content that is informative, customized for their procedure and patient journey stage, and empathetic. STREAMD supports 20 languages, which means that patients receive guidance and can query chatbots in the language they are most comfortable with.

STREAMD improves patient experiences and outcomes, while also helping clinical staff communicate more efficiently.

We carefully plan facilities to match local demand. That said, demand for ASC access is growing quickly, and our health system and physician partners are looking for ways to meet that need in their communities.

For example, while we are developing Frisco Station Surgery Center to open as a 12,000-square-foot facility with four operating rooms; the ASC has the capacity to expand to a 16,000-square-foot facility with six operating rooms in the future. This scalability will allow the facility to expand seamlessly alongside patient demand, ensuring long-term sustainability for the physicians who operate there.

Jeffrey Flynn

Flynn is the chief executive officer of Gramercy Surgery Center, a multi-specialty ASC operator with locations in New York City and Queens, and the president of the New York State Association of Ambulatory Surgery Centers.

Specifically in New York State, many centers will be directing capital toward implementing Cardiac programs as the state is about to approve the CMS approved cardiac codes for ASCs.

Currently, we are prohibited from performing these procedures. In other areas, we will be committing more capital toward further developing spine, joint replacements and GYN. Robotics is going to be a serious discussion in the ASC setting.

Steve Hockert

Hockert is the chief development officer at Solara Surgical Partners, a long-standing, privately held company that develops and manages a growing portfolio of ASCs across the United States.

At Solara Surgical Partners, we maintain a steadfast commitment to our empower-and-support model, whereby growth initiatives generate organically at the local, facility level. These initiatives are subsequently scrubbed for their intended goals and communicated back to local governance for decision making.

Proper deployment of scarce resources is unique to each center, their specific objectives and their financial circumstance. We have some centers with excess capacity that are considering allocating dollars toward new service-line deployment within their existing facility footprint, while others are near capacity and are considering building modifications to add more operating and procedure rooms.

That being said, cardiac and orthopedic service lines continue to be targeted growth opportunities, along with the related technologies to deploy them in a quality manner.

In addition, we’ll advocate for robotics, AI-driven workflow tools and patient engagement platforms where they directly support clinical excellence, operational efficiency and patient experience. Investing in innovations that remove friction for physicians while enhancing care delivery and the overall patient experience is always a high priority in these rapidly evolving times. It is certainly an exciting time to be in the industry!

Danilo D’Aprile

D’Aprile is the business development for Merritt Healthcare, which develops, manages and advises ambulatory surgery centers nationwide.

In 2026, our capital priorities will focus on preparing centers for growth trends in the industry. That includes expanding service lines such as cardiovascular and potentially investing in technology like robotics and AI platforms, as well as upgrading facilities (where necessary) to support higher-acuity procedures.

We generally design and budget our facilities with growth in mind. Our centers are intentionally built with capacity for expansion, whether that means shell space, oversized core infrastructure (HVAC, electrical, life-safety), or layouts that allow for additional ORs and recovery bays. This type of planning avoids expansion delays and helps flex to meet growth demands.

Other investment areas include compliance readiness (e.g., cybersecurity) and staff/leadership development (recruitment, retention, and training programs).

Todd Currier

Currier is the CEO of Bend Surgery Center, a large multi-specialty surgery center in Oregon. 

In 2026, we will be looking to enhance and maximize the use of technology within our multi-specialty Center.

From Patient focused software to internal clinical operations, we look forward to taking full advantage of available efficiencies. We will be investing in equipment and instrumentation to expand our capabilities within our orthopedic and spine specialties, as well as continue to review and evaluate the use of soft-tissue robotic-assisted surgery systems. We expanded back in 2022, and we continue to add surgeons within our center while expanding each surgical specialty.

Wes Battiste

Battiste is a senior advisor with Avanza Healthcare Strategies. He is also the CEO and founder of Destin Surgery Center.

In 2026,  ASCs will look to invest significantly in additional service-line recruitment. The same-store pipelines are limited, but with the expansion of allowable procedures in CMS’ proposed ruling and potential elimination of the IPO list, the growth market is expanded. In an effort to take advantage of these positive tailwinds, we (Avanza Healthcare Strategies) are seeing many health systems seek to develop or expand their current ASC portfolio.

Specifically, we see cardiovascular, total joint and spine targeted in new developments. The expansion of service line offerings in ASCs will also require investment in physician recruiting, capital equipment and potential physical facility renovations to accommodate this additional, new volume.

Patrick Stamm

Stamm is the chief operating officer of TriasMD.

We are always evaluating opportunities to expand our service offerings to meet the evolving needs of our patients. We are committed to providing the best spine and orthopedic care available anywhere. Many of the added services we are evaluating for inclusion in our network are focused on expanding conservative care options and perioperative care.

In terms of technology, innovation is a core part of our business philosophy. We are constantly exploring new ways to expand care and drive better outcomes. Equally important is finding ways to reduce the cost of care for patients and our payer partners. With cost of care continuing to outpace inflation, it is important to our patients to find ways to keep costs down.

We are also investing in actions to reduce the complexity around finding and getting care. We are making improvements to our contact center, streamlining the authorization process with payers, and adding technology in our ASCs to improve efficiency and reduce delays. We believe these investments will not only boost our operational efficiency but also enable us to deliver more sophisticated and customized solutions for our network and our patients.

To support our continued growth, we are constantly evaluating potential facility expansion. We opened our DISC Surgery Center at Carlsbad (San Diego County) this spring and our DISC Surgery Center at Tarzana (Los Angeles County) will begin operations in October. Additionally, we are completing construction of the DISC Surgery Center at West Palm Beach (our first location outside of California) in preparation for an opening later this year. This is a strategic move to enhance our ability to serve a new geographic area with our unique patient care model.