Summary4 min read

Podcast Summary

Podcast: Becker’s Healthcare Podcast
Guest: Brenda Fernández, MBA, Chief Financial Officer, Puerto Rico ASC Holding
Host: Gracelyn Keller
Recording Date: December 20, 2025
Event: 31st Annual Business and Operations of ASCs

Episode Overview

This episode explores the dynamic and rapidly evolving Ambulatory Surgery Center (ASC) landscape in the U.S., focusing on financial stewardship, innovation, and technology integration. Brenda Fernández, CFO of Puerto Rico ASC Holding, shares her insights on key market trends, crucial strategies for ASC leaders, and the transformative impact of partnerships and advanced technology on care delivery and operational efficiency.

Key Discussion Points and Insights

1. Background and Current Role

[00:57–01:44]

Brenda Fernández oversees a network of ASCs in Puerto Rico, including two single-specialty ophthalmic centers and one multi-specialty center with the island’s first outpatient total joint program.
Her responsibilities center on financial stewardship, sustainable growth, strategic investment, payer contracting, capital allocation, and operational efficiency.
Brenda works closely with both clinical and administrative leaders to ensure every dollar spent aligns with high-quality, cost-effective, compliant care.

Notable Quote:
"My role focuses on financial stewardship and sustainable growth, overseeing strategic investment, payer contracting, capital allocation, and operational efficiency."
— Brenda Fernández [01:08]

2. Market Growth Drivers and ASC Leadership Priorities

[01:44–03:09]

The ASC market is projected to reach $60.8 billion by 2030, with strong year-over-year growth.
Significant trends fueling this expansion:
- Payer incentives and patient preference
- Volume shift from hospitals to ASCs, especially in orthopedics and ophthalmology
- Innovation in technology and processes
Strategies for ASC leaders:
- Build robust financial structures around case and payer mix to anticipate margin compression.
- Strengthen revenue cycle management, coding accuracy, and denial management.
- Align capital investments in technology and infrastructure with ROI projections.
- Diversify partnerships and participate in bundled payment models to stay competitive in value-based care.

Notable Quotes:
"The shift of surgical volume from hospital to ASCs, especially orthopedics and ophthalmology, creates meaning cost savings for the system while maintaining quality..."
— Brenda Fernández [02:15]

"For ASC leaders, the priority should be scaling in a strategic way... also aligning capital investment in technology and infrastructure with volume-based return on investment projections."
— Brenda Fernández [02:30]

3. The Role of Technology and AI in the Future of ASCs

[03:09–04:28]

Technology and AI are redefining ASC operations.
Data-driven decision-making distinguishes leading centers.
AI and automation enable:
- Real-time prediction of case profitability
- Staffing optimization
- Benchmarking supply utilization and implant costs
- Pinpointing billing/documentation leakage
Advanced analytics sharpen board-level reporting by connecting operational metrics with financial impact (e.g., turnover, length of stay, infection rates).
The next evolution: integrated dashboards combining quality, staffing, and cost metrics.

Notable Quotes:
"From my perspective, data-driven decision-making is now the differentiator between good and great centers."
— Brenda Fernández [03:32]

"AI and automation are allowing us to predict case profitability and optimize staffing in real time."
— Brenda Fernández [03:38]

4. Opportunities Through Partnerships and Collaborations

[04:28–05:40]

Collaboration with health systems and vendors unlocks significant value:
- Health systems provide brand and complex case pathways; ASCs offer efficiency and cost advantages.
- Joint venture expansions: hospitals contribute volume and capital, ASCs deliver operational excellence.
- Vendor/implant agreements based on cost-performance or volume rebates.
- Cross-provider networks allow bundled episodes for surgery, rehab, follow-up—enhancing continuity and facilitating shared savings.
The future financial model: collaborative, transparent, and based on shared risk and reward.

Notable Quote:
"Partnerships are where real value is being unlocked... The financial model of the future is collaborative—share risk, share reward, and align transparency."
— Brenda Fernández [04:43, 05:32]

5. Final Thoughts: Financial Literacy and Strategic Growth

[05:45–06:15]

Financial literacy for ASCs transcends balancing budgets: it’s about building resilient and adaptable systems.
The greatest challenge: Remaining lean while making bold, strategic investments.
Successful centers will blend disciplined cost management with aggressive strategic growth.
Technology and collaboration act as "capital multipliers" when executed with precision.

Notable Quote:
"Financial literacy in the ASC world today means more than balancing books. It's about designing resilient systems. Technology and collaboration are not just enablers—they are capital multipliers when executed with precision."
— Brenda Fernández [05:45, 06:11]

Notable Quotes & Memorable Moments (with Timestamps)

On the CFO role in ASCs:
"My role focuses on financial stewardship and sustainable growth, overseeing strategic investment, payer contracting, capital allocation, and operational efficiency."
— Brenda Fernández [01:08]
On the ASC market transformation:
"The shift of surgical volume from hospital to ASCs, especially orthopedics and ophthalmology, creates meaning cost savings for the system while maintaining quality..."
— Brenda Fernández [02:15]
On data-driven decision-making:
"From my perspective, data-driven decision-making is now the differentiator between good and great centers."
— Brenda Fernández [03:32]
On value in partnerships:
"Partnerships are where real value is being unlocked... The financial model of the future is collaborative—share risk, share reward, and align transparency."
— Brenda Fernández [04:43, 05:32]
On the importance of financial literacy:
"Financial literacy in the ASC world today means more than balancing books. It's about designing resilient systems... Technology and collaboration are not just enablers—they are capital multipliers when executed with precision."
— Brenda Fernández [05:45, 06:11]

Key Timestamps

[00:57–01:44] — Brenda’s background and role
[01:44–03:09] — ASC market growth, leaders’ strategies
[03:09–04:28] — Impact of AI and technology on ASC operations
[04:28–05:40] — Opportunities in collaborations and partnerships
[05:45–06:15] — Final thoughts on financial literacy and resilient systems

Conclusion

Brenda Fernández provides a comprehensive perspective on the evolving ASC industry, emphasizing that disciplined financial management, advanced technology, and collaborative partnerships are key to future success. This episode is packed with actionable insights for ASC leaders aiming to scale sustainably and thrive in an increasingly complex healthcare environment.

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Transcript13 lines

[00:00]
A
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[00:36]
B
Is Gracelyn Keller with the Beckers Healthcare Podcast and we are recording live of the 31st annual business and operations of ASCS. I'm currently joined by Brenda Fernandez who is the Chief Financial Officer at Puerto Rico ASC Holding. So Brenda, thanks for being here. I'm going to have you kick us off by sharing a little bit more about yourself and your work in the ASC space.
[00:57]
C
Yeah, first thank you for the invite. I currently serve as a Chief Financial Officer of a network of ASEs in Puerto Rico. Our portfolio includes 2 single specialty in ophthalmic ASEs and 1 multi specialty with the first outpatient total joint program on the island. My role focus on financial stewardship and sustainable growth, overseeing strategic investment, payer contracting, capital allocation and operational efficiency. I work closely with the clinical and administrative leaders to ensure that every dollar spent aligns with our mission which is delivering high quality, cost effective care in a compliant and scalable environment.
[01:44]
B
Wonderful. Well thanks for being here and let's start our conversation by talking about the ASC market in the US. This is projected to reach CP $60.8 billion by 2030 and it continues to experience strong year over year growth. So from your perspective, what is the most significant trend and market forces driving this expansion and how should ASC leaders be preparing today?
[02:07]
C
Well the growth is being fueled by a combination of payer incentive, patient preference and innovation. From a financial lens, the shift of surgical volume from hospital to ases, especially orthopedics and ophthalmology. This creates meaning cost saving for the system while maintaining quality so there are opportunities in the market. So for ASC leaders the priority should be scaling in a strategic way. For example build strong financial motors around case mix and payer mix to anticipate margin compression. Also straighten revenue cycle performance, eligibility coding accuracy and denials management. Another priority might be aligned capital investment in technology and infrastructure with volume based return on investment projections and the last one but not minor diversity partnerships and bundled payment participation to stay competitive in A value based environment.
[03:09]
B
Wonderful. And then from AI and robotic surgeries to advanced EHR systems, technology remains both a make or break factor and a critical driver of ASC operations at scale. So how do you see deeper tech integration shaping the ways ASCs deliver care and manage their business over the next few years?
[03:26]
C
AI is a trending topic in this era. Technology is quickly becoming the great equalizer for ASCs. From my perspective, data driven decision making is now the differentiator between good and great centers. AI is an automation are allowing us to basically predict case profitability and optimize staffing in real time. Also doing some benchmark supply utilization and implant costs against national data sets. Also identify leakage points in billing or documentation that directly affect cash flow. Advanced analytics also make our board level reporting sharper. We can tie operational metrics directly to their financial impact like turnover, lend of state and infection rates among others. The next frontier is integrated dashboards that link quality outcomes, staffing and cost per case on one platform.
[04:28]
B
And with 60% of health systems considering ASC joint ventures and many ASCs already partnering with systems in their communities, what opportunities do you see for collaboration whether with other providers or vendors to strengthen patient care and operational efficiency?
[04:44]
C
Partnerships are where real value is being unlocked. Health systems bring brand recognition and complex case pathways. ASES brings efficiency and lower cost structures. There are too many opportunities in the market, so some of them include joint venture expansions where hospitals contribute case volume and capital and ASCs provide operational excellence. Another opportunity might be vendor and implant partnerships tied to cost per case performance or volume based rebates. And also I think that cost provider networks it could be another opportunity for bundle episodes, surgery rehab and follow ups to enhance continuity of care and capture share savings. The financial motto of the future is collaborative share risk, share reward and align transparency.
[05:40]
B
Well, thank you so much for taking the time to join me today. Is there anything we didn't touch on or any final thoughts you'd like to share?
[05:46]
C
Absolutely. Financial literacy in the ASC world today means more than balancing books. It's about designing resilient systems. Our challenge is to remain lean while investing in the right innovations. The centers that thrive will be those that combine discipline in cost management with boldness in strategic growth. Technology and collaboration are not just enablers, they are capital multipliers when executed with precisions.
[06:16]
B
Wonderful. Well Brenda, thanks so much for joining me. And again we are recording live at the 31st annual Business and Operations of ASCS. Thanks so much.
[06:24]
C
Thank you.