The big disruption of small ASCs
As the healthcare landscape continues to shift, new data suggests that smaller ASCs may hold the advantage in today’s market.
According to ASC software company HST Pathways’ latest “State of the Industry Report,” the dynamics of ASC performance are tilting in favor of leaner, more specialized facilities.
Here are five things to know:
1. HST Pathway’s survey of 590 ASCs found a stark contrast in revenue performance between small and large ASCs. From 2023 to 2024, ASCs operating with just two operating rooms reported a 22% increase in year-over-year revenue. In contrast, facilities with 15 or more ORs saw their revenue decline by 8%.
“This surge may indicate that smaller ASCs are becoming more efficient or are better positioned to adapt to market demand,” the report said. “These trends suggest a shifting dynamic in ASC performance, with smaller centers thriving while larger ones face headwinds.”
2. HST CEO David Thawley told OR Manager this was an “amazingly interesting data point” that underscores the importance of optimizing operating room utilization.
3. Other ASC leaders are echoing this sentiment, pointing to the operational advantages of smaller, more focused facilities. Benjamin Stein, MD, an orthopedic surgeon and co-founder of Capital Surgical Solutions, told Becker’s in August that size isn’t everything, rather specialization is.
“A lot of the larger surgery centers, many of them are broad, multispecialty centers, which I think is a significant flaw in some respects, because when you’re trying to get ahead, it’s all about routine,” he said “If you look at it from a clinical perspective, catering to the clinical deployment of a single specialty means your staff — your sterilization departments, both operating room and recovery staff, anesthesia staff — will all be much more knowledgeable, efficient and targeted in the care they provide if they can focus on one specialty.”
4. The trend toward hyper-specialization isn’t new. In maturing ASC markets, the need to offer a broad array of procedures is diminishing. Instead, some ASCs are opting to double down on a single subspecialty, a model that allows staff and physicians to master their surgery lines and deliver more consistent, higher-quality care.
5. Charles DeCook, MD, orthopedic surgeon at the Cumming, Ga.-based Advanced Center for Joint Surgery, told Becker’s in 2023 that ASCs are financially stable enough to focus on specialization.
“These ‘super-specialized’ ASCs will offer better trained staff and support to the surgeon as well as more focused care, outcomes and satisfaction to the patient,” he said. “ASC specialization mirrors the specialization that has already occurred with surgeons.”
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