Why Ambulatory Surgery Centers Are on the Rise

  • Industry trends
  • 7/2/2025

Key insights

  • Ambulatory Surgery Centers (ASCs) are increasingly popular for outpatient surgeries, with more than 10,000 centers in the U.S. and a projected revenue growth from $45 billion to $57 billion by 2030.
  • While ASCs face rising operational costs, they remain a more affordable option compared to hospitals, appealing to cost-conscious consumers and insurers.
  • Innovations in clinical practices and technology are enabling more procedures to be safely performed in ASCs, enhancing operational efficiency.

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What do ACL repairs, cataract surgery, and colonoscopies have in common? They’re all surgeries or procedures that can be done as outpatients in ambulatory surgery centers (ASCs) — and their volumes are growing. ASCs provide outpatient surgical procedures to patients who do not require an overnight stay at a hospital. There are more than 10,000 ASCs nationwide, with the majority being Medicare-certified.

Source: IBIS World

ASCs overall had $45 billion in revenues in 2024. The industry is projected to grow to $57 billion by 2030. (Source: Ambulatory Surgery Centers in the U.S., IBIS World, September 2024)

As your ASC considers the current market environment and future growth opportunities, keep these factors in mind and consider some next steps you can take in response.  

Seven factors driving ASC growth

1. Demographics

By 2030, all baby boomers — 75 million or more than 20% of the population — will have reached Medicare eligibility. The sheer size of this population is why more ASCs are becoming Medicare-certified, including 155 new ASCs in 2023 that saw volumes rise 5.7%. Looking out further, an aging population will likely use more health care services, including outpatient procedures. 

2. Site of service shifts

Care continues to shift from higher cost settings toward more efficient care settings, such as ASCs, when clinically appropriate. Employers and consumers are driving care towards ASCs as they seek cost efficiency and convenience. 

The Medicare program has also moved various surgeries from inpatient to outpatient settings, adding some cardiac procedures as well as ankle and shoulder reconstructions to ASCs in recent years. Each time Medicare does so, this provides opportunities for growth. 

3. Single specialty focus

Most ASCs have a single specialty like orthopedics, gastroenterology, ophthalmology, or pain management. For Medicare-certified ASCs, 68% specialize in one service, typically gastroenterology or ophthalmology. Adding additional specialties that align with existing ones provides new growth opportunities.

 

Source: MedPAC

 

4. Cost as a headwind, tailwind

As with all health care, ASCs face increasing supply, labor, and administrative costs. Managing these costs is key. However, growing health care costs also translate into a tailwind for ASCs since they are lower cost when compared to hospitals.

As consumers grow more cost conscious, options like ASCs can help reduce consumers’ out-of-pocket spend. The same holds true for insurers and employers as they look to control their health care costs and look to ASCs over hospitals.

5. Independence vs. transactions

While some ASC owners may want to remain independent, others may be interested in selling or partnering. Hospitals and health systems are making significant investments into new ambulatory centers, including ASCs. They are also interested in joint ventures with existing ASCs or even acquisitions. 

Private equity and corporate ownership have increased due to current industry fragmentation. For example, five corporate entities — United Surgical Partners International, AmSurg, Surgical Care Affiliates, HCA Healthcare, and Surgery Partners Holdings — are considered major holders and have increased their degree of ownership by 15.7% in the past few years. 

6. Clinical practice, technology

Advancements in clinical practice and technology will likely lead to more procedures being safely provided in the ASC setting. Artificial intelligence can assist ASCs in streamlining and automating administrative functions, enabling financial stability and growth.

7. Consumer preference

Consumers want access, comfort, and ease of scheduling. ASCs can offer more convenient locations, shorter wait times, lower cost sharing, and easier scheduling. 

Next steps on your ASC’s path to success

As ASC owners, how you analyze and use these opportunities for growth remains up to you. 

First, consider the factors and how these relate to your ASC and your market:

  • Your market includes an aging demographic. How should you prepare for the movement of patients from commercial payers into Medicare? 
  • You spend far too much time on manual and administrative tasks. Have you assessed how digital and technology solutions can help create efficiencies (time, money)?
  • Your finance function is bare bones and could use help. Would an outsourced professional better serve your existing staff and your ASC?
  • You know more procedures — cardiac, ankles, and others — continue to provide opportunities for growth. Have you analyzed or developed a growth strategy? 
  • You have successfully built your ASC and had a wonderful career, but now is the time to retire. Are your tax strategies, estate planning, and wealth management all in order? 
  • You have an offer to merge into a hospital nearby, but your desire is to remain independent. What steps should you take?

Second, if you find yourself interested in a transaction

  • Review and understand your existing contracts in detail
  • Work to advance strategies that fully leverage all available reimbursements
  • Implement any options for maximal case volumes
  • Bring your balance sheet into order
  • Review any compliance and legal related documents to confirm all is in order
  • Consider ages of owners and impact on case volumes

How CLA can help you grow your ASC 

Whatever is important to your ASC for the future — financial improvements, business operation, growth, joint ventures or even for acquisition — CLA’s ASC and health care practice can help. Reach out today.  

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Enhance patient care, boost efficiency, and position your ambulatory surgery center for growth. Complete the form below to connect with CLA.
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