Becker's ASC Review

9 THOUGHT LEADERSHIP 10 things brightening ASCs' futures By Francesca Mathewes F rom shis toward site-neutrality to projected increases in patient volumes, there are a number of developments in healthcare that spell good news for ASCs and their future growth. Here are 10 recent developments, policy updates and statistics exciting ASC leaders: 1. e Transforming Episode Accountability Model from CMS is set to go into effect Jan. 1, 2026, which ties payments to hospitals to the total cost of care, as well as quality of care delivered across an entire surgical episode. Eddie Qureshi, CEO of Rainfall Health, told Becker's that this policy update could represent a major shi for the ASC industry. "Not to be too dramatic, but I think it is leagues different from everything that's come before. is one is really moving and trying to create a blueprint for the next generation of outcome- based care," he said."CMMI is saying that we're going to tie in everybody from an ASC to a hospital to primary care to hospice, everything together into one episode. It's going to actually put ASCs more front and center wherever possible, because there's a huge financial component to this model as well. Care coordination is at the center of it. Quality is going to be part of the reimbursement model." 2. Nearly 50 health insurers, representing commercial, Medicare Advantage and managed Medicaid plans covering 257 million Americans, recently committed to simplifying and standardizing the prior authorization process, and ASC administrators are approaching the announcement with cautious optimism. ese participating payers have pledged to implement a standardized electronic prior authorization system by Jan. 1, 2027, with the goal of enabling real-time approval for at least 80% of electronic prior authorization requests by that date. 3. Orthopedics, one of the most prolific specialties among ASCs, topped the list of highest-paid physicians in 2024 4. North Carolina, New York, Tennessee and Georgia are all evaluating proposals that would scale back certificate-of-need regulations. ese policy shis could modernize what many ASC leaders see as outdated thresholds and easy regulatory burdens to improve access to surgical care. 5. Cardiology, a fast-growing ASC specialty, has seen continuous growth in recent years — exciting many ASC leaders. In 2022, 65% of outpatient peripheral vascular interventions among Medicare beneficiaries were performed in office-based laboratories, according to an article published July 7 in JACC. e volume of cardiovascular services performed in ASCs is projected to grow 15% between 2023 and 2028. Between 2018 to 2023, the number of single-specialty cardiology ASCs grew from 55 to 221, accounting for 4% of all Medicare-certified ASCs in the U.S. 6. Despite growing consolidation, ASCs remain largely independent. Independently owned ASCs made up 67% of the market in 2024, down slightly from 68% in 2023, according to a report from VMG Health. 7. As many ASCs fight to remain independent, Becker's has reported on numerous ASC companies and management services organizations pioneering models to support — rather than acquire — independent practices. 8. Healthcare consulting group Sg2, a Vizient company, released its "2025 Impact of Change Forecast" on June 23, laying out several growth trends that will impact ASCs over the next 10 years. e report projects total adult ASC volume to grow 21% over the next decade. 9. e report also highlights a projected 18% growth in adult outpatient volumes and a 5% increase in adult inpatient discharges over the next decade. 10. e report further noted that as more procedures are approved for the ASC setting, outpatient volumes overall are expected to reach 6.03 billion by 2035. Annual inpatient discharges are expected to reach 31.9 million by the end of the decade, with those ages 65 and older accounting for more than half of these discharges. n Will ASC migration harm hospital care? 1 surgeon weighs in By Cameron Cortigiano W ith more physicians and surgeons moving towards outpatient and ASC settings, one leader is concerned about the impact it could have on hospital care. If too many physicians start providing care at ASCs full time, there may not be enough staff on hand at hospitals, medical centers and other non-ASC facilities, leading to a dip in patient care. Michael Firstenberg, MD, medical director of cardiothoracic surgery and Department of Surgery Chair of Maui (Hawaii) Memorial Medical Center, recently connected with Becker's to share concerns about a trend that could develop in the next six months. Question: What will be the biggest trend that emerges in the ASC industry during the second half of 2025? Dr. Michael Firstenberg: It is concerning that as more and more physicians, surgeons and proceduralist perform all of their procedures at ASCs – who is going to cover "hospital call" if they are no longer able and/or willing to cover call, especially when it is "their" patients and procedures that have problems and complications and need to go to the hospital. Who will take care of these patients going forward? n

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