Recorded live at the New York State Association of Ambulatory Surgery Centers conference in Albany, NY (Oct 6-8), this special edition episode brings three vantage points on where ambulatory surgery is headed next: Dr. Daniel Choi of Spine Medicine & Surgery of Long Island on scaling a multi-physician practice with 10,000+ annual visits and what it really takes to plan an ASC; JoAnn Vecchio of ASC of Western New York on sustaining growth and continuity through a partnership with Catholic Health; and Kara Newbury of ASCA on how a federal shutdown could affect timelines and current legislation — and what ASC leaders should prioritize now amid uncertainty. One theme connects them all: ASCs are built for this moment — safer care, smarter costs, and real runway for growth — if you can execute. Resources mentioned: Ambulatory Surgery Center Association (ASCA) [https://www.ascassociation.org/home] Brought to you by HST Pathways.
This week, Will Evans, Head of Data Science & Insights at HST Pathways, joins us to unpack our new five-and-a-half-year look at how case volume, OR minutes, and dollars are distributed across patient demographics. We discuss the biggest findings, a few surprises, and the simple metrics any ASC can track to anticipate scheduling and staffing nuance by population. In our news segment, we cover venture fundraising in the ASC industry, a recent survey report showing a growing number of health systems making ASCs a core part of their strategy, how cyberattacks have disrupted patient care at hundreds of healthcare organizations this year, and a new FDA-cleared blood test to aid in initial Alzheimer's assessments. Resources mentioned: Report: Who's on Your Schedule? Demographic Trends & Benchmarks for ASCs [https://www.hstpathways.com/specialty-data/asc-demographic-data] Oath Surgical Raises $24M to Expand Surgeon-Led Centers, Develop AI Platform [https://ascnews.com/2025/10/oath-surgical-raises-24m-to-expand-surgeon-led-centers-develop-ai-platform/] Health systems expand ambulatory strategies: Report [https://www.beckersasc.com/asc-news/health-systems-expand-ambulatory-strategies-report/] In 2025, patients are in the healthcare cybersecurity crosshairs [https://www.healthcareitnews.com/news/2025-patients-are-healthcare-cybersecurity-crosshairs] Roche, Lilly's blood test for Alzheimer's diagnosis gets US approval [https://www.reuters.com/business/healthcare-pharmaceuticals/roche-lillys-blood-test-alzheimers-diagnosis-gets-us-approval-2025-10-13/] Brought to you by HST Pathways.
In this episode, Benita Tapia, Administrator & Director of Nursing at Beverly Hills ASC, joins Alex — along with Conor McGinn, CEO of Akara — to unpack how she's using AI to improve everyday operations: tightening block utilization and surgeon accountability, speeding turnovers, answering scheduling questions in real time, and boosting registration accuracy to cut preventable denials. We also cover the guardrails — privacy, policy, and a human in the loop — that keep these tools safe and useful. In our data segment, we look at Otolaryngology benchmarks from nearly 112,000 cases across 202 centers. OR block utilization sits around 46%; net revenue per case is up 26% ($2,981 to $3,765); deposits slipped, and denials ticked up while days to bill improved. We highlight trends to watch, and simple steps leaders can take now to tighten collections, curb denials, and move closer to that 70% utilization goal. Resources mentioned: HST Pathways State of the Industry Report [https://www.hstpathways.com/resources/surgery-center-industry-report/] HST Pathways Otolaryngology Benchmark Report [https://www.hstpathways.com/specialty-data/otolaryngology] Brought to you by HST Pathways.
As Q3 wraps, this episode spotlights the signals that matter for ASC leaders heading into the busiest quarter of the year. We track policy direction, the continued shift of cases to outpatient settings, and how employer data transparency is accelerating site-of-care redirection. We scan market momentum and partnerships, revisit anesthesia coverage and how centers are adapting, and share pragmatic AI wins that tighten schedules and improve RCM. Skim the quarter's major ASC trends in under 20 minutes to guide Q4 execution and set up 2026 planning. Resources mentioned: CMS proposed CY-2026 OPPS/ASC rule [https://www.cms.gov/newsroom/fact-sheets/calendar-year-2026-hospital-outpatient-prospective-payment-system-opps-and-ambulatory-surgical] ICD-10-CM FY-2026 code update [https://www.cms.gov/medicare/coding-billing/icd-10-codes] National Alliance of Healthcare Purchaser Coalitions Pulse of the Purchaser 2025 Survey [https://www.nationalalliancehealth.org/resources/pulse-of-the-purchaser-2025-survey-results/] Tenet Reports Strong Second Quarter 2025 Results; Raises 2025 Financial Outlook [https://investor.tenethealth.com/press-releases/press-release-details/2025/Tenet-Reports-Strong-Second-Quarter-2025-Results-Raises-2025-Financial-Outlook/?utm_source=chatgpt.com] Ascension nears $3.9B AmSurg acquisition: Bloomberg [https://www.fiercehealthcare.com/providers/ascension-nears-39b-amsurg-acquisition-bloomberg?utm_source=chatgpt.com] Avanza Strategies 6th Hospital Leadership ASC Survey [https://avanzastrategies.com/wp-content/uploads/2025/05/6th-Avanza-Intelligence-Hospital-Leadership-ASC-Survey.pdf] JAMA Surgery, Effect of a Predictive Model on Planned Surgical Duration Accuracy, Patient Wait Time, and Use of Presurgical Resources [https://pmc.ncbi.nlm.nih.gov/articles/PMC7841577/] Becker's ASC Annual Meeting, October 16–18, Chicago [https://conferences.beckershospitalreview.com/31st_Annual_ASC_Meeting_2025] Brought to you by HST Pathways.
For the final episode of our Improving the Patient Experience series, show co-host Grant Duncan and Marta Shultz, a clinical workflow expert at HST Pathways, join Alex to unpack pre-assessments — why they're essential for patient safety and satisfaction, when to complete them, how many forms you actually need, and practical ways ASC leaders can reduce nurse phone time and cut cancellations and delays. In our data segment, we analyze gynecology benchmarks from 33,000+ cases across 99 centers. OR block utilization fell 10% year over year to 41%, while a number of financial metrics improved. We cover trends to watch, and steps leaders can take to curb operational challenges at their own centers. Resources mentioned: HST Pathways State of the Industry Report [https://www.hstpathways.com/resources/surgery-center-industry-report/] HST Pathways Gynecology Benchmark Report [https://www.hstpathways.com/specialty-data/gynecology] Brought to you by HST Pathways.
Jeffrey Flynn, Administrator and Chief Operating Officer at Gramercy Surgery Center and President of the New York State Association of Ambulatory Surgery Centers, joins the show to share how Gramercy keeps care personal at scale — training every team member as a patient advocate, keeping families informed, and even empowering nurses to call a case when something feels off. He also gives us insight into what the NYSAASC has been up to and previews what's ahead for New York ASCs as we approach next month's state conference in Albany. In our news recap, we'll cover why anesthesia providers are choosing ASCs, CMS's proposed 2.6% payment update and additions to the ASC-Covered Procedures List fueling industry growth, ASCA's July 60-Second Survey on EHR adoption, and a nationwide study in New Zealand using AI to speed stroke imaging. In or near New York? Join us at the NYSAASC Conference in Albany, NY, at the Desmond Hotel, October 6-8, 2025. [https://www.nysaasc.org/nysaasc-conferences] Resources mentioned: Why anesthesia providers are drawn to ASCs [https://www.beckersasc.com/anesthesia/why-anesthesia-providers-are-drawn-to-ascs/] The policy shifts driving the ASC boom [https://www.beckersasc.com/new-asc-development/the-policy-shifts-driving-the-asc-boom/] ASCA Survey Shows Continued Growth of EHR Usage by ASCs [https://www.ascfocus.org/ascfocus/content/articles-content/articles/2025/digital-debut/asca-survey-shows-continued-growth-of-ehr-usage-by-ascs] National rapid stroke imaging AI study underway in New Zealand [https://www.healthcareitnews.com/news/anz/national-rapid-stroke-imaging-ai-study-underway-new-zealand] Brought to you by HST Pathways.
In this episode, Grant Duncan sits down with Katie Sypher, a registered dietitian and healthcare operations leader, and Michael McClain, founder of LeftCoast Healthcare Advisors, to tackle one of the most overlooked challenges in the ASC space: communication. They share practical strategies for aligning messaging between clinics, surgery centers, and patients — covering everything from mapping touchpoints to creating a single source of truth to reduce duplication, avoid confusion, and build patient trust. After that, tune into our Data & Insights segment, where we explore why ASCs saw claim denial rates drop from 8% to 4% in 2024 — a 50% improvement — and what your center can do to replicate that success. Resources Mentioned: 2024 State of the Industry Report by HST Pathways [https://www.hstpathways.com/resources/surgery-center-industry-report/] Brought to you by HST Pathways.
Colleen Ramirez, Chief Administrative Officer at Bone & Joint Surgery Center of Novi, and Dr. Michael Bernard, Director of Anesthesia, join the show to share how they work together to drive case volume, choose which cases to accept, and stay profitable—all while maintaining a strong clinical partnership. In our news recap, we'll cover the first ever ASC in the Dominican Republic, a new ASC joint venture, the rising demand for dental surgeries, and, of course, end the news segment with a positive story about how engineers have discovered a way to turn dental floss into a vaccine. Lastly, an exciting update: starting next week, Erica Palmer will be handing over hosting duties to Alex Larralde! Resources Mentioned: * One World Surgery Opens First Ever ASC in DR [https://www.ascfocus.org/ascfocus/content/articles-content/articles/2025/digital-debut/one-world-surgery-opens-first-ever-asc-in-dr] * Solara Surgical Partners, Orlando Health Announce New ASC Joint Venture [https://ascnews.com/2025/07/solara-surgical-partners-orlando-health-announce-new-asc-joint-venture/] * Demand Rises for Dental Surgery in ASCs [https://www.ascfocus.org/ascfocus/content/articles-content/articles/2025/august/demand-rises-for-dental-surgery-in-ascs] * Engineers transform dental floss into needle-free vaccine [https://www.science.org/content/article/engineers-transform-dental-floss-needle-free-vaccine] Brought to you by HST Pathways.
This week, we're joined by Wes Battiste, an experienced anesthesiologist and ASC developer, to talk about a growing trend: surgery centers building their own in-house anesthesia teams. What once seemed like a wild idea is now becoming the best path forward for centers looking to stay profitable. Then, in our Data & Insights segment, we dive into 10 key metrics from spine centers—some promising, some concerning, but all worth paying attention to. Plus, a personal update: After nearly three years hosting This Week in Surgery Centers, Erica Palmer will be passing the mic. You'll meet your new host, Alex Larralde, in this episode (she interviews Wes!), and you'll also start hearing from Grant Duncan in the coming weeks. Resources Mentioned: https://www.hstpathways.com/specialty-data/spine Brought to you by HST Pathways.
Alex Taira from ASCA breaks down the key takeaways from CMS's 2026 Proposed Payment Rule for ASCs. From reimbursement rates to the ASC Covered Procedures List and quality reporting changes, Alex shares what ASC leaders need to know from the 913-page proposal. In our news recap, we highlight an AI-JAMA partnership, payer challenges facing anesthesiologists, tips to prevent cyberattacks, and a breakthrough device preserving donor organs. ASCA Resources: * Proposed Rule Highlights [https://www.ascassociation.org/asca/news-and-publications/ga-update/2025/07-17] * Propsed Rule Webinar on 7/22/25 [https://www.ascassociation.org/asca/education-and-events/virtual/2025-regulatory-series/understanding-medicares-proposed-rule-for-2026] * ASCA's 60-Second Survey [https://www.surveymonkey.com/r/ASCA60Survey_EHR] * National Advocacy Day [https://www.ascassociation.org/national-advocacy-day-2025/home] News Stories: * JAMA signs multi-year deal with OpenEvidence [https://www.fiercehealthcare.com/ai-and-machine-learning/jama-signs-multi-year-deal-openevidence-inform-ai-powered-medical-search] * The payer issues pressing anesthesiologists [https://www.beckersasc.com/anesthesia/the-payer-issues-pressing-anesthesiologists/] * Offensive Mindset: Preventing Cyberattacks [https://www.aorn.org/outpatient-surgery/the-magazine/article/offensive-mindset] * 'Life-saving' organ-preserving device wins major award [https://www.positive.news/society/good-news-stories-from-week-28-of-2025/] Brought to you by HST Pathways.
This week, ASC expert Carol Hiatt joins us to share practical tips for improving OR utilization in orthopedic surgery centers. With over 30 years in the industry, Carol dives into common causes of underutilization and how to fix them. Then in our Data & Insights segment, we spotlight dental ASCs. Drawing from 35 facilities and over 15,000 cases, we break down key metrics like block utilization, pre-auth rates, and patient deposit collection. Resources Mentioned: https://www.hstpathways.com/specialty-data/dental Brought to you by HST Pathways.
Kevin Turner is the Sr. VP of IT & Analytics at HealthCrest Surgical Management. He has been in IT for over 30 years and has been through the software evaluation process countless times. Kevin shares with us his repeatable, proven, 8-step process that anyone can use to guide their software decisions. Whether you're choosing your first system or replacing a legacy tool, this structured approach will help you navigate the process with confidence. With so many vendors and features to consider, it's easy to feel overwhelmed, but this step-by-step process will keep you focused on what matters most and make sure all stakeholders are happy with the decision. In our news recap, we'll cover the DOJ's Anticompetitive Regulations Task Force, Ascension's acquisition of AMSURG, the biggest opportunity for growth in ASCs, and, of course, end the news segment with a positive story about a nurse who uses her own personal tragedy to provide once-in-a-lifetime care. Recommend 8-Step Process: 1. Define Business Needs and Objectives 2. Assemble a Cross-Functional Selection Team 3. Gather Requirements and Prioritize Features 4. Research the Market and Identify Potential Vendors 5. Evaluate and Compare Options 6. Assess Integration, Security, and Compliance 7. Review Costs and Negotiate Contracts 8. Pilot, Test, and Finalize the Decision Resources Mentioned: * ASC Stakeholders Voice Market-Competition Concerns, Ask DOJ Task Force to Cut Red Tape [https://ascnews.com/2025/06/asc-stakeholders-voice-market-competition-concerns-ask-doj-task-force-to-cut-red-tape/] * Ascension agrees to acquire Amsurg to expand ambulatory surgery reach [https://www.healthcaredive.com/news/ascension-acquire-amsurg-asc/750938/] * The biggest opportunities for ASC growth [https://www.beckersasc.com/leadership/the-biggest-opportunities-for-asc-growth/] * From Paralyzed Patient to Spinal Cord Nurse: Rachel Stewart, BSN, RN, Turns Trauma into Triumph [https://www.dailynurse.com/rachel-stewart-nurse-spinal-cord-injury-journey/] Brought to you by HST Pathways.
At the end of every discussion, we always ask our guests, "What is one thing our listeners can do this week to improve their surgery centers?" For today's episode, we took the last 15 answers we received from our guests and turned them into a 20-minute highlight reel. This roundup features, in order: Scott Allen, Becky Ziegler-Otis, Tina DiMarino, Kathy Wilson, Ryan Short, Colin Park, Mayte Rechani, Mark Henderson Leary, Maddie Traylor, Richard Parker, Melanie Howitt, Kristle Young, Josh Rudd, Nyleen Flores, Shannen Reyes-Aguayo, and Will Evans. A huge thank you to everyone who has shared their advice! Brought to you by HST Pathways.
Will Evans, HST's Senior Director of Data Science and Insights, is fresh off presenting Advanced Financial Strategies at last month's ASCA conference. I wanted to spend a few minutes with Will recapping the second half of that presentation for those who may have missed it, including four key metrics for assessing financial health, how to identify the most important metrics for your unique ASC, and ways to incorporate benchmarking. If you're looking to strengthen your ASC's financial performance, this is a great place to start—and you'll hear a success story or two along the way. After my conversation with Will, we'll shift to our Data & Insights segment. You're likely familiar with our full State of the ASC Industry Report, but we recently released 12 new specialty benchmarking reports—shorter, data-focused reports that take a deeper dive into one specialty at a time. Today, I'll spotlight average monthly revenue trends for two longstanding specialties—Gastroenterology and Ophthalmology—versus two emerging specialties—Cardiology and Total Joints. We'll break down average monthly case volume, revenue per case, and what trends we're seeing across these specialties. Resources Mentioned: * https://www.hstpathways.com/specialty-data/gastroenterology/ * https://www.hstpathways.com/specialty-data/ophthalmology/ * https://www.hstpathways.com/specialty-data/cardiovascular/ * https://www.hstpathways.com/specialty-data/totaljoint/ Brought to you by HST Pathways.
Nyleen Flores, CEO of MedElevate, and Shannen Reyes, President of Advanced Quality Compliance, are joining us today. With decades of experience between them, Nyleen and Shannen have helped countless surgery centers streamline their credentialing processes, reducing risk and improving patient safety along the way. In this episode, we unpack common misconceptions, share tools and systems that actually work, and chat about their brand-new podcast, Credentialing Chronicles. Later in the episode, I'll walk through our latest Data & Insights spotlight. You've probably seen our full State of the ASC Industry Report, but we've just released 12 new benchmarking reports focused on specific specialties. Today, we're focusing in on Cardiovascular ASCs—with insights from 108 centers and roughly 9,000 cases. Resources Mentioned: https://www.hstpathways.com/specialty-data/cardiovascular Brought to you by HST Pathways.
Josh Rudd recently opened Knoxville Spine Surgery Center, his first time leading the launch of a brand-new facility. I sat down with Josh to hear what the process was really like, from the initial idea all the way to their very first procedure. Whether you're planning a new build or just curious about what it takes to open an ASC from scratch, this conversation is packed with first-hand insights you'll find both valuable and engaging. After my conversation with Josh, we'll head into our Data & Insights segment. HST released its annual State of the Industry report in September, based on data from 590 surgery centers. Today, we're diving into expected vs. actual OR start times and sharing practical tips to help keep your schedule running on time. Resources Mentioned: HST's State of the Industry Report [https://www.hstpathways.com/resources/surgery-center-industry-report/] Brought to you by HST Pathways.
We're continuing our series on Improving Profitability. Last week, Melanie Howitt shared how AI and automation can improve your ability to collect outstanding balances. This week, Kristle Young from Collective RCM joins us to discuss strategies for reducing days in AR. In our news recap, we cover key trends from the ASCA Conference, the rise of shoulder replacements, a new joint venture between Cleveland Clinic and Regent Surgical, and end on a high note with this year's Nap Gary Award recipient. Resources Mentioned: ASCA 2025 Recap: Profitability, Tech, and Leadership [https://www.hstpathways.com/blog/asca-2025-recap-profitability-tech-and-leadership/] Gaining Ground [https://www.aorn.org/outpatient-surgery/the-magazine/article/gaining-ground] Cleveland Clinic, Regent Surgical Strike ASC Joint Venture Agreement [https://ascnews.com/2025/05/cleveland-clinic-regent-surgical-strike-asc-joint-venture-agreement/] Wilson Receives Nap Gary Award for Lifetime Achievement [https://www.ascfocus.org/ascfocus/content/articles-content/articles/2025/names-in-the-news/wilson-receives-nap-gary-award-for-lifetime-achievement] Brought to you by HST Pathways.
We're kicking off a brand-new three-part series on Improving Profitability at Your ASC. First up: Melanie Howitt, Transition and Implementation Manager at in2itive, joins host Nick Latz to discuss how AI and automation can streamline collections and reduce outstanding balances. She also shares field-tested best practices for optimizing the back end of the revenue cycle. Then, in our Data & Insights segment, we dive into findings from HST's latest State of the Industry report. With data from 590 surgery centers, we break down the most common reasons for case cancellations—and which ones your ASC can work to prevent. Resources Mentioned: HST's State of the Industry Report: https://www.hstpathways.com/resources/surgery-center-industry-report/ How to Create a CustomGPT: https://www.youtube.com/watch?v=_u0tHytmKqw Brought to you by HST Pathways.
HST CEO David Thawley recently joined ASCA's podcast to discuss key ASC trends in 2024—from rising specializations and OR efficiencies to new RCM data from our State of the Industry Report. We're excited to share that conversation here with permission from ASCA. Quick reminder: if you're listening on Tuesday, April 29, the ASCA conference is officially underway! Come visit us at Booth #303 to say hi, grab your copy of the report, and win a prize. Check out ASCA's podcast, Advancing Surgical Care: https://www.ascassociation.org/asca/news-and-publications/podcast Download HST's State of the Industry Report: https://www.hstpathways.com/resources/surgery-center-industry-report/ Brought to you by HST Pathways.
Today's guest is Richard Parker, Associate Director of Life Safety & Physical Environment at ACHC—the Accreditation Commission for Health Care. We talk about what life safety includes, what surveyors are really looking for, how to document properly, and the most common deficiencies ACHC sees during surveys. Reminder: the ASCA conference is just two weeks away! If you haven't registered yet, online registration closes Friday, April 18th, so now's the time to register if you haven't yet. HST will be there at Booth #303, right up front in the exhibit hall. Stop by to say hello, grab a copy of our State of the Industry report, take a quiz for a chance to win a prize, and check out all our latest solutions. We hope to see you there. Resources Mentioned: * Closing the ASC Tech Gap: EHRs, AI and Beyond [https://ascnews.com/2025/04/closing-the-asc-tech-gap-ehrs-ai-and-beyond/] * How ASCs can flip the script on anesthesia challenges [https://www.beckersasc.com/anesthesia/how-ascs-can-flip-the-script-on-anesthesia-challenges/] * Streamlining the PACU Experience for Total Joints Patients [https://www.aorn.org/outpatient-surgery/the-magazine/article/streamlining-the-pacu-experience-for-total-joints-patients] * The dog-tor will see you now [https://www.positive.news/environment/good-news-stories-from-week-13-of-2025/] * Learn more about ACHC Webinars: https://www.achc.org/ Brought to you by HST Pathways.