Eric Gonzales and Alexandra DeHart are healthcare banking leaders at Columbia Bank, where they work with healthcare organizations on financing, growth, and capital planning. Eric and Alexandra join us this week to break down how ASC leaders should think about funding growth. They walk through the key differences between debt and equity, what ownership and control trade-offs come with each path, and which financial metrics lenders care about most — including EBITDA, revenue growth, leverage, fixed charge coverage, payor mix, stabilization, and quality of financial reporting.

In our data segment, we’re connecting the conversation back to HST’s 2026 State of the ASC Industry Report. We’ll look at how operational and financial metrics like net collection rate, OR utilization, cancellation rates, specialty mix, and case profitability can help ASC leaders build a stronger, more bankable growth story before pursuing expansion, adding physicians, or taking on new capital.

Resources Mentioned: HST’s 2026 State of the ASC Industry Report [https://www.hstpathways.com/resources/surgery-center-industry-report/]

Brought to you by HST Pathways.

What Lenders Want to See Before You Expand 

Quality data can be one of the most powerful tools an ASC has to improve both safety and operations. In this episode, Nina Goins, Executive Director of the ASC Quality Collaboration, explains how centers can use benchmarking data to uncover deeper operational issues, strengthen payer and board conversations, and build a stronger culture of quality. She also shares why measures like wrong-site events and unplanned hospital transfers matter so much, how ASCQC’s Safety and Quality Assessment can help centers benchmark best practices, and why a simple daily safety huddle can make a meaningful difference.

In our news recap, we’ll cover the latest wave of ASC development, Leapfrog’s expansion of public ASC quality reporting, new research showing how outpatient surgery growth is creating uneven access across communities, and why anesthesia remains one of the biggest operational risks to ASC growth.

Brought to you by HST Pathways

Using Quality Data to Improve ASC Operations

Thank you for taking the time to listen to our report. We hope you learned many insightful and actionable tips to continue providing excellent patient care in a way that is efficient and profitable.

Operating a successful ASC is not the same as it was a decade ago or even five years ago. The industry is undergoing transformative changes, shaped by factors such as regulatory changes, technological advancements, evolving patient expectations, and economic pressures.

Leading surgery centers, with their finger on the pulse of these changes, recognize the emerging challenges. They understand traditional methods will no longer cut it, and a proactive approach is essential. HST Pathways is committed to riding this wave alongside our clients and partners, and we will navigate whatever the future holds together.

HST Pathways is the leading provider of a suite of products that have been thoughtfully and clinically designed for the surgery center industry. Our software offerings provide ASCs with intuitive solutions that cover the entire patient journey and help to unlock revenue, fuel growth, and deliver better care. Build, grow, and run your facility with solutions your entire team will love. See why more than 1,800 ASCs and 75,000 users are choosing HST Pathways by visiting our website, hstpathways.com. This has been the State of the ASC Industry Report, published in 2026. Thank you for listening.

View the full report online: https://www.hstpathways.com/resources/surgery-center-industry-report/

57 – Closing Message & About HST Pathways 

This report was developed using a comprehensive approach that included industry research, consultations with clinical experts, data from reputable industry publications, and insights from HST Pathways’ own products.

When benchmarking data was sourced from HST Pathways’ data warehouse, the conclusions in this report were based on data spanning the beginning of 2023 through 2025, representing three full years of ASC data. Year-over-year comparisons include full calendar year data from 2023, 2024, and 2025. The surgery centers represented are HST clients who have granted permission for their data to be used in this analysis, offering a comprehensive and current view into the trends and dynamics shaping the industry today.

View the full report online: https://www.hstpathways.com/resources/surgery-center-industry-report/

56 – Methodology 

Before we wrap up, let’s take a moment to define the key metrics used throughout this report, along with how each one is calculated. They are listed in the order they appear in the report.

View the full report online: https://www.hstpathways.com/resources/surgery-center-industry-report/

55 – Metric Definitions & Formulas 

The ninth and final task that you should complete annually is reviewing legal compliance.

View the full report online: https://www.hstpathways.com/resources/surgery-center-industry-report/

54 – Annual Tasks: Review legal compliance 

The eighth task that you should complete annually is reviewing policies and procedures.

View the full report online: https://www.hstpathways.com/resources/surgery-center-industry-report/

53 – Annual Tasks: Review policies and procedures 

The seventh task that you should complete annually is renewing licenses and certifications.

View the full report online: https://www.hstpathways.com/resources/surgery-center-industry-report/

52 – Annual Tasks: Renew licenses and certifications 

The sixth task that you should complete annually is reviewing vendor contracts.

View the full report online: https://www.hstpathways.com/resources/surgery-center-industry-report/

51 – Annual Tasks: Vendor contract review 

The fifth task that you should complete annually is preparing the annual budget.

View the full report online: https://www.hstpathways.com/resources/surgery-center-industry-report/

50 – Annual Tasks: Prepare annual budget 

If you’re in the ASC industry, then you’re in the right place. Every episode, our hosts will recap the important news and data impacting ASCs, and share an interesting conversation we had with an expert from the industry. Check back often for new episodes!

This Week in Surgery Centers

This is the third edition of the HST State of the ASC Industry Report, now in podcast form. Built from a comprehensive dataset representing 682 centers across 45 states and nearly 4.8 million patient visits, this series goes beyond surface-level trends. Across each episode, we break down 139 KPIs, 50 charts, 23 year-over-year comparisons, and six emerging trends, all drawn from three full years of data from 2023 through 2025. Start from the beginning or jump to the episode that matters most to you. We hope you find the information and data helpful.

This Week In Surgery Centers

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