From regulatory barriers and challenges to continually increasing costs paired with consistently stagnant reimbursements, here are some of the biggest roadblocks and hurdles to ASC and physician practice growth in 2025, according to industry leaders.
These five executives, physicians and administrators recently connected with Becker’s to share some of the top challenges the industry is facing when it comes to growth and expansion.
Note: Responses were lightly edited for clarity and length.
Andrew Gwinnell. Executive Director of Truvista Surgery Center (Troy, Mich.): The tariff issues impacting both cost and procurement of supplies has been challenging to manage. Governmental policy fluidity creates an environment where we are constantly re-evaluating supply arrangements and P&L forecasts.
John Donovan, MD. Otolaryngologist at ENT Salem (Ore.): As reimbursement rates fail to keep pace with rising practice costs, how can physician practices sustain themselves long-term? Private practices cannot sustain themselves indefinitely given these conditions. There is an absolute limit to physician [work relative value units] production. Once that is reached in any practice, falling payments and general inflation in tandem become an unstoppable tide. This leaves one sustainable option; transition from private practice to an employed model.
Joe Peluso. Administrator at Aestique Surgical Center (Greensburg, Pa.): Rising healthcare costs are not sustainable, since the burden is felt by patients and businesses every day through higher premiums and out-of-pocket costs. Americans are concerned about being able to pay for healthcare services and the viability of Medicare in the future. Solutions must address the misaligned incentives that are fueling cost growth.
Policymakers must take action, despite lobbying and partisan politics, in at least seven areas to address some of the root causes of rising healthcare costs: We need to focus on what matters most: taking care of patient healthcare needs.
Shakeel Ahmed, MD. CEO of Atlas Surgical Group (St. Louis): The ASC industry continues to face multiple obstacles in their expanding market around the country and worldwide in general. In the U.S., our biggest hurdles are regulatory barriers, including political opposition from special interest groups, worsening payer dynamics and difficult physician-owner recruitment around the country. As far as political issues go, ASCs continue to struggle with highly restrictive certificate-of-need laws around the country, with an uphill battle to overcome these hurdles. Medicare also has failed to keep pace with inflation. Reimbursement disparities are progressively unsurmountable for most surgery centers, especially the smaller ASC.
Andrew Lovewell. CEO of Columbia (Mo.) Orthopaedic Group: Physician workforce trends certainly have an impact on the ASC landscape. The ASC landscape is being shaped by a growing shift toward physician employment, with more surgeons joining hospital systems, limiting the pool of independent physicians available for ASC partnerships. However, many physicians are still looking for autonomy and control over surgical outcomes and demanding that ASCs be an option even in hospital employment. In addition, many consumers (patients and payers) are looking for an ASC as an alternative to the traditional hospital environment. Independent ASCs must adapt by offering innovative ownership models, increased autonomy and competitive financial incentives to attract and retain top surgical talent. If independent ASCs partner with hospitals in joint venture models there could possibly be win-wins that create long-term success.
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