Podcast Summary: Becker’s Healthcare Podcast

Guest: Eliza Auguste, Administrator, Precision Care Surgery Center

Host: Gracelyn Keller (Becker's Healthcare)
Date: November 2, 2025
Event: 31st Annual Business and Operations of ASCs

Overview

In this episode, Gracelyn Keller welcomes Eliza Auguste, Administrator of Precision Care Surgery Center, to discuss the accelerating evolution of ambulatory surgery centers (ASCs) in the U.S. Together, they explore key industry trends, the role of technology, vital strategies for growth, and the significance of collaborative partnerships. Eliza draws on her extensive experience to offer practical advice for ASC leaders on adapting to a changing market landscape.

Key Discussion Points & Insights

Eliza’s Background in the ASC Industry

• Eliza has over 15 years in ASC management and operations, rising from front desk work in high school to Administrator, and also serves as VP of her state ASC association.
• “I have done almost every nonclinical function in an ASC… worked my way up to administrator.” (00:55)

Trends and Market Forces Expanding the ASC Sector

• Shifting Case Types:

  • Technology enables more complex procedures in the ASC setting, including total joints, shoulders, ACDF, and even cardiac cases.
  • “Years ago, total joints in the ASC was not even a thing and now here we are doing total joints, total shoulders... there's cardiac in the ASC space.” (01:45)

• Payer and Employer-Driven Forces:

  • Insurance payers actively encourage surgeries to move from hospitals to ASCs for cost savings.
  • Employers pursue direct contracts with ASCs, bypassing traditional insurance to reduce costs for self-funded plans.

• Patient Cost Sensitivity:

  • Escalating costs in healthcare and daily living drive patients to seek more affordable, high-quality care—ASCs are often the answer.

• Preparation for Growth:

  • Carefully assess and prepare before launching new service lines; detailed planning is essential.
  • Invest in staff development and specialty expertise, both hiring externally and upskilling current teams.
  • Robust revenue cycle management is critical: “If you’re not prepared to really handle [billing nuances], you’re going to be doing all these cases and not maximizing the revenue you need…” (02:56)

Technology’s Transformative Impact on ASC Operations

• Integrated Pre-Op and Patient Journeys:

  • Real-time tracking from registration to discharge; enhanced data sharing with referring physicians and hospitals, often via state health information exchanges.
  • “We’re really able to live-track patient journeys from registration all the way to the end of their journey…” (04:05)

• AI for Coding, Documentation, and Denial Management:

  • AI helps streamline administrative tasks, improve coding accuracy, and reduce denials in claim processing.
  • “...predict the mistakes ahead of time to be able to correct your coding so that you're maximizing your revenue.” (04:38)
  • Critical for sustaining operations: “If you’re not making any money, you can’t continue operations. And then you end up closing—which patients end up suffering.” (04:50)

• Supply Chain Optimization:

  • Technology assists in tracking spending and case costing, reducing financial waste and ensuring sustainable operations.
  • “Supply chain management… is one of the first places that people don’t realize they’re losing money…” (05:13)

Most Impactful Technologies

• AI-Assisted Coding:
  • Eliza highlights her center’s focus on deploying AI tools that align facility and physician coding, read operative reports, and flag documentation gaps.
  • “...looking into technologies that are really based on AI coding—where it can read a claim, or read an OP report... and determine if the codes we’re looking to bill actually align with the documentation…” (05:44)

Opportunities for Collaboration and Partnerships

• Hospital Joint Ventures (JVs):

  • Eliza advocates for JVs to function as genuine partnerships, with ASCs handling lower-acuity cases while hospitals focus on higher acuity.
  • “...ASCs and hospitals, even though they are partnered together on paper, a lot of times... do not partner together very well... Realistically, we should just be an extension of each other.” (06:43)

• Payer Partnership Leverage:

  • Partnerships with hospitals can give ASCs more negotiating power with payers for better rates.

Final Thoughts and Advice for ASC Leaders

• ASCs’ Enduring Role:

  • “ASCs are here to stay. We are expanding, we’re growing. We’re relentlessly consistent, patient safe, data driven, financially disciplined.” (07:32)

• Pragmatic Innovation:

  • Avoid chasing every technology trend (“shiny object”); instead, pick tools and partnerships that truly compress timelines, streamline workflows, and improve outcomes.
  • “You don’t want to increase your workload and... hardship of trying to run your facility. You want to make things as easy as possible for yourself and your staff while still providing a high quality of care.” (07:59)

• People Come First:

  • Investing in staff is fundamental to care quality and operational success.
  • “Your people are really what matter because they are the ones providing care to your patients. If you do not invest in them, they will not invest in the quality of care for your patients.” (08:13)

Memorable Quotes

• “Years ago, total joints in the ASC was not even a thing and now here we are doing total joints, total shoulders... there's cardiac in the ASC space.” — Eliza Auguste (01:45)
• “If you’re not making any money, you can’t continue operations. And then you end up closing—which patients end up suffering.” — Eliza Auguste (04:50)
• “ASCs are here to stay... We’re relentlessly consistent, patient safe, data driven, financially disciplined.” — Eliza Auguste (07:32)
• “Do not chase every single shiny object... pick technologies and partnerships...that will compress your timelines and your workflows, improve your outcomes, and just overall really be a good fit for your facility.” — Eliza Auguste (07:55)
• “Your people are really what matter... If you do not invest in them, they will not invest in the quality of care for your patients.” — Eliza Auguste (08:13)

Timestamps for Key Segments

• Guest introduction and background — 00:55
• ASC market trends and opportunities — 01:41
• Preparing for new service lines and revenue optimization — 02:30
• Role of technology—EHR, AI, supply chain — 04:03
• AI-assisted coding and real-world application — 05:41
• Collaboration: hospital JV opportunities and payer leverage — 06:35
• Advice to ASC leaders; summary messages — 07:31

Conclusion

This episode provides a pragmatic, firsthand look at the forces reshaping ambulatory surgery centers, the strategic adoption of technology, and the vital importance of culture and partnerships in driving success. Eliza Auguste’s guidance is centered on smart growth, effective tech implementation, and continual investment in people—offering ASC leaders a concise playbook for navigating a rapidly changing healthcare sector.