Elisa Auguste, Administrator, Precision Care Surgery Center

Summary

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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

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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.

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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)

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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)

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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)

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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)

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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.

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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)

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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)

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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

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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.

Transcript

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[Gracelyn Keller]

Is Gracelyn Keller with the Beckers Healthcare Podcast and we are recording live at the 31st annual Business and Operations of ASCS. I'm currently joined by Eliza August who is the Administrator of Precision Care Surgery Center. So Eliza, thanks for being here. And to kick us off, let's have you share a little bit more about yourself and your work in the ASC space. Sure.

[Eliza August]

As she said, I'm Eliza. I have been in the industry for about 15 years, if not more at this time. I do run a orthopedic center out in East Talket, Long Island. I am also the Vice president of my state association as well. A little fun fact. I have done almost every non clinical function in an ASC from the time I was probably in high school starting out working at front desk and worked my way all the way up to administrator.

[Gracelyn Keller]

Wonderful. And let's have our conversation begin with the ASC market because in the US it's projected to reach $60.8 billion by 2030 and continues to experience strong year over year growth. So from your perspective, what are the most significant trends in market forces driving this expansion and how should ASC leaders be preparing today?

[Eliza August]

Sure. So I'll start with the trends. I believe like one of the first trends is the migration of appropriate cases to the ASC space. As technology basically is improving, we're doing more and more cases in the as. Years ago total joints in the ASC was not even a thing and now here we are doing total joints, total shoulders. We're doing ACDF cases. Now there's cardiac in the ASC space. Second also is really, I would say payer pressure and really employer steerage. So payer pressures, multiple payers are realizing the, I guess cost savings of migrating all of their surgeries from the hospital space to the ASC space to the point that payers are now creating programs targeting ASCs to say, hey listen, we will help drive volume to your facility. If you can get these cases done for us, you know, at a lower rate. You also have employer groups that are doing direct employer with healthcare facility negotiations, cutting out the middleman of the insurance, looking for cost savings, especially for these self funded plans. You also have to look from perspective of cost inflation for patients in this industry now. You know, healthcare is, the costs are rising, patients are having rising costs everywhere across the board, from food, housing, health care, and they're looking for ways to still get appropriate care at a cost effective way. And ASCs are the answer and I would say in regards to preparing, to be honest with you, if you're a surgery center and you're considering doing, let's say a new service line, really assess and plan for new service lines and have a really solid plan of how to implement them. Also really invest in your team. Whether it's hiring new people that are experts in certain fields, whether it's billing or let's say it's a nurse that does a particular specialty or really just training the people that you have in house to really be prepared to handle influxes of volume and different specialty. Also making sure that you're really assessing your revenue cycle process. There are different billing nuances with all types of specialties. If you're not prepared to really handle it, then you're going to be doing all these cases and not maximizing the revenue you need to be able to actually handle the cost of providing services.

[Gracelyn Keller]

And 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 scale. So how do you see deeper tech integration shaping the way ASCs deliver care and manage their business over the next few years?

[Eliza August]

So I will say with the rise in tech, first and foremost, basically integrated pre op journeys, we're really able to live track patient journeys from registration all the way to the end of their journey when they're discharged from their asc, as well as being able to share information with other physicians, other hospitals, whether that's through centralized health exchanges, depending on the state that you're in, I believe like that's really impacting health care and being able to make proper healthcare decisions for your patients. Next, a lot of it really is AI when it comes to AI for coding and documentation and taking some of those nuanced little workflows basically that really could be done by a computer and basically targeting your people to do other things so that you're still being efficient as possible. Also really denial management. We're in an industry where dealing with physicians, they'll code basically certain Procedures, let's say, and there's mistakes and being able to predict the mistakes ahead of time to be able to correct your coding so that you're maximizing your revenue. Because as we know as an asc, we rely heavily on our revenue to continue operations. If you're not making any money, you can't continue operations. And then you end up closing which patients end up suffering. And then I would say lastly supply chain management. That probably is one of the, I would say probably first places that people don't realize that they're losing money because you're spending, spending spending, not tracking what you're spending, not properly case costing, not basically you're taking on case maybe that you can't afford to do and not realizing it because you're not actively effectively using technology to really track it and.

[Gracelyn Keller]

Follow up to that. Is there a single technology or innovation that stands out to you as especially transformative?

[Eliza August]

I can speak for myself personally. My center has had some challenges in regards to coding, alignment between facility and physician coding. And we're looking into technologies that are really based on AI coding where it can read a claim essentially, or read an OP report and read the patient's implant log and physician's last consult and determine based basically, if the codes that we're looking to bill actually align with the documentation, it'll tell you if there's opportunities for improvement in your actual documentation. If there was a missed code or if something that you're billing, it just doesn't make sense to help kind of prevent your denial management. So that's less work on the back end for my revenue cycle team.

[Gracelyn Keller]

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?

[Eliza August]

I would say from the standpoint of hospital JVs really working with the ASCs and not viewing ASCs as competition, but more so as partnership, maybe offloading, let's say the lower acuity cases to the ASC space so that the hospital could take on the higher acuity cases. We're in an industry right now where ASCs and hospitals, even though they are partnered together on paper a lot of times from operational perspective, do not partner together very well. And they view each other almost as competition for the same surgeries, the same physicians, when realistically we should just be an extension of each other, then I do say that there is opportunity with the hospitals when it comes to payer partnerships. One standalone ASC has a struggle negotiating rates for itself, but partnering with the hospital, that gives you more negotiating power to negotiate better rates, basically having that partnership with your hospital.

[Gracelyn Keller]

Well, Eliza, thanks so much for joining me today. Is there anything else that we didn't touch on or final thoughts you'd like to share?

[Eliza August]

So I would just like to say that ASCs are. We're here to stay. We are expanding, we're growing. We're relentlessly consistent, patient safe, you know, data driven, financially disciplined. I would say, though, as an ASC leader, do not chase every single shiny object, basically, that's out there. Really do your homework. Pick technologies and partnerships, basically that will compress your timelines and your workflows, improve your outcomes and just overall really be a good fit for your facility. You don't want to, I guess, increase your workload and increase your basically 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. And the last thing I would say is invest in your people. 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. Wonderful.

[Gracelyn Keller]

Well, thanks for being here and thanks for joining me on the Backers podcast again. We are recording live at the 31st annual business and operations of ASCS.

[Eliza August]

Thank you.