Issue link: https://beckershealthcare.uberflip.com/i/1544360
12 THOUGHT LEADERSHIP The triple-threat of ASC challenges ahead By Francesca Mathewes e ASC industry faces an array of pressures in the year ahead, from rising costs and payer issues and a struggling physician workforce. As the demand for surgical services in the U.S. intensifies with an aging population, many ASC leaders are honing in on efficiency, optimization and long-term investments in patient experience. Jessica Pfister, senior director of operations of ambulatory services and Rachel Carpenter, BSN, RN, associate director of ambulatory surgical services at Ohio State Wexner Medical Center in Columbus, recently joined Becker's to identify the biggest challenges ahead for their organization. Editor's note: Responses have been lightly edited for clarity and length. Question: What are the three biggest operational challenges your ambulatory services are facing in the next year? Ms. Pfister and Carpenter: 1. Operating Room Utilization and Block Management Ensuring optimal utilization of ASC operating rooms remains a priority. is includes refining block allocation, improving transparency around block release timing and aligning cases to the most appropriate surgical site based on acuity, equipment needs and staffing models. 2. Surgeon Alignment and Scheduling Efficiency Balancing surgeon availability across multiple sites while creating consistency and predictability in ASC schedules is an ongoing challenge. Continued engagement with surgeons and schedulers is critical to improving throughput, reducing underutilized time and strengthening ASC identity. 3. Robotics Integration ere is a clear trend toward robotic surgery across several specialties, with newer surgeons increasingly trained primarily on robotic platforms rather than traditional laparoscopy. Surgeons expect access to this technology, and we are actively evaluating the feasibility of introducing robotics into the ASC environment. is includes assessing capital investment, case volume thresholds, staffing competencies and overall return on investment. n Where physician expenses are climbing most By Francesca Mathewes I nflation remains one of the biggest concerns for ASC and physician practice leaders as costs from everything from supplies to real estate continue to rise at a rate faster than that of reimbursement increases. Inflation, measured by the Consumer Price Index, rose 2.7% from December 2024 to December 2025, according to the Bureau of Labor Statistics. When it comes to physician practice expenses, labor costs were one thing that has seen a steady increase in the last year. The median level of investment required to support a physician full- time equivalent in a practice rose to $343,128 in the fourth quarter of 2025, according to data from Strata Decision Technology. This represents a 3.4% increase in cost compared with Q3 and an 11.5% increase from Q4 of 2024. Physician expenses also rose in Q4, with total expense per physician FTE hit about $1.2 million for the quarter, up 6.3% from Q2 and up 8.9% from Q4 of 2024. But costs are not increasing at the same rates nationwide. Per-physician FTE expenses increased most sharply in the Midwest and Northeast, rising from 12.1% and 13.7% from Q4 2024 to Q4 2025, respectively. Practices in the South and West also experienced significant increases, with expenses up 7.4% and 9.6%, respectively, over the same period. n