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Becker’s Healthcare Podcast
Scott Becker - 12 Trends We Are Watching in the Surgery Center Space 8-19-25
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This is Scott Becker with the Becker's Healthcare Podcast. Today's discussion is trends and stories that we're watching related to surgery centers. And so many of these trends relate to healthcare as a whole. And then we'll get down to more specific to surgery centers. First, there's an increasing supply and demand problem in healthcare. We talk about this a lot, the change in balance between the supply of physicians and the needs of our 345 million people. This has a big impact on health care and also big impact on surgery centers who rely very much on surgeons for procedures. Second, as we've discussed, often the payers, particularly the four biggest payers, United, Aetna, Cigna, Anthem or Slash Elevance, have tremendous power compared to the providers. The four payers, the four largest payers earn the four largest 20 companies in the US by revenue. That just gives you one data point as to their differences in power between that and let's say an individual surgery center or even a surgery center change. Third, there's all this discussion about if we just change the payment system, this will fix health care, that will fix health care. We're a big believer that whether the payment system is value based care or fee for service, the real problem is supply and demand and too much administrative cost versus the payment system. Yes, we can use and we need improved pay for hospitals and surgeons and physicians. But here I'm talking about this content in this narrative that a failure based care system is a panacea. We just don't see that. We think it's going to be really need to fix the supply and demand problem and how we deliver care, not the payment system. But people disagree with me. Fourth, there's this also this concept of technology and preventive care can be a panacea. They're very, very important, but ultimately labor and doctors to go with the technology, the prevention and more. Fifth, currently there's about 6,300 Medicare certified surgery centers in the country. That number has grown some over the years, but it's not grown dramatic medically at all, notwithstanding all the discussion out there, but the growth in outpatient surgery. Sixth, you're seeing more migration of procedures to surgery centers and to outpatient, but relatively slow growth in the total number of ambulatory surgery centers that are Medicare certified. Seventh, we're still seeing in the ASC universe rising expenses and reimbursement pressure, more and more government pay as a percent of total pay, harder and harder to recruit independent physicians to ASCs and related practices. Just a sign of the times is there's less and less independent physicians, even though the numbers in surgically in the key key surgical specialties have stayed relatively healthy in terms of and that's very important surgery centers, because independent physicians are the lifeblood available in surgery centers. Ninth, the four key specialties for surgery centers remain ophthalmology, orthopedics, pain management and GI. 30% of all procedures are eye procedures, 12% are GI, 50% orthopedic, 10% are pain management. But again, those specialties very, very important to surgery centers. Tenth, the independence of specialists remains the lifeblood of ASCs. That number is getting worse, but it's not disastrous yet. Eleventh, anesthesia shortages, which are very important. Surgery centers remain very critical in many markets. We're continuing to see that. And finally, 12th, the three biggest ASC chains are USPI, SCA Health and AMSURG. USPI is a part of Tennant, Sea Health is a part of Optum, and Amsurg has become part of Ascension. Surgery Partners is fourth, and HCA is the chain with the next largest number of surgery centers. So that's what we're watching the surgery centers again. Those are 12 overall trends. And then we'll talk about, you know, later on in different podcasts, some specific stories about surgery centers, too. Thank you for listening to the Beckers Healthcare Podcast.