Here's what to expect on this week's episode. 🎙️

Amy Swaffer, Director at Knoxville Spine Surgery Center, joins us from HST Connect to share what it took to move from 22 years at a Level I trauma center into the ASC industry and help build a de novo surgery center from the ground up.

Amy breaks down the learning curve that comes with entering the ASC world, why she surrounded herself with people who were stronger than her in key areas, and how her team built workflows around both patients and staff. She also shares her approach to leadership, supporting employees, and listening to the people doing the work every day to identify opportunities for improvement.

We also get into how Knoxville Spine Surgery Center responded when its original anesthesia group could no longer provide coverage. Amy explains why the center ultimately built its own anesthesia group, the benefits they've seen from having that relationship in-house, and what ASC leaders need to consider around staffing, coverage, and communication before taking a similar approach.

Then, we're covering some of the latest news impacting the ASC industry, including insurers steering certain elective procedures toward ASCs, CMS's new CJR-X joint replacement model, and increased regulatory scrutiny surrounding ASC acquisitions.

Plus, HST Pathways has been nominated in several categories for the inaugural Ambulatory Surgery Center News Product of the Year Awards. Voting is open through September 30, and we'd really appreciate your support.

And to end things on a lighter note, we're looking at new research on how therapy dogs are helping patients stay engaged and active during stroke rehabilitation.

Resources Mentioned:

ASCN Product of the Year Awards – Vote for HST Pathways [https://poyawards.ascnews.com/nominees]

Two Insurers Started Steering Patients to ASCs. Here's What Happened Next – Ambulatory Surgery Center News [https://ascnews.com/2026/08/two-insurers-started-steering-patients-to-ascs-heres-what-happened-next/]

CJR-X Comprehensive Care for Joint Replacement Expanded Model – CMS [https://www.cms.gov/priorities/innovation/innovation-models/cjr-x]

FTC Approves Final Consent Order in Ascension Health-AmSurg Deal – Federal Trade Commission [https://www.ftc.gov/news-events/news/press-releases/2026/08/ftc-approves-final-consent-order-ascension-health-amsurg-deal]

Mayo Clinic Study Highlights Benefits of Animal-Assisted Treatment in Stroke Rehabilitation – Mayo Clinic [https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-study-highlights-benefits-of-animal-assisted-treatment-in-stroke-rehabilitation/]

Brought to you by HST Pathways.

What It Takes to Build and Lead an ASC From the Ground Up

Here's what to expect on this week's episode. 🎙️

Terry Ross, Group President, Prevention & Recovery at Enovis, joins us to break down what the NO PAIN Act means for ASCs. He explains how the law creates a Medicare reimbursement pathway for qualifying opioid-sparing treatments and what centers should know about clinical evidence, implementation, and reimbursement.

In this week's news recap, we cover new bipartisan legislation focused on Medicare ASC payments, what recent HCA and Tenet results reveal about case mix, and Anthem's moderate-sedation reimbursement changes.

Resources Mentioned

Guest Discussion

 * Enovis NOPAIN Act Resources [https://enovis.com/nopain-act]
 * CMS: Non-Opioid Treatments for Pain Relief [https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient-pps/non-opioid-treatments-pain-relief]
 * Study: The Use of Cold Therapy Following Arthroscopic Rotator Cuff Repair [https://pubmed.ncbi.nlm.nih.gov/41110819/]

News Recap

 * Outpatient Surgery Access Act of 2026 [https://www.govinfo.gov/app/details/BILLS-119s4963is]
 * Tenet Healthcare: Second Quarter 2026 Results [https://investor.tenethealth.com/press-releases/press-release-details/2026/Tenet-Reports-Strong-Second-Quarter-2026-Results-Raises-2026-Financial-Outlook/default.aspx]
 * HCA Healthcare: Second Quarter 2026 Earnings Call [https://investor.hcahealthcare.com/news/news-details/2026/HCA-Healthcare-Inc--2nd-Quarter-2026-Earnings-Conference-Call/default.aspx]
 * Anthem: Moderate Sedation Reimbursement Policy [https://files.providernews.anthem.com/8011/ME-RP-New-Moderate-Conscious-Sedation.pdf]

Brought to you by HST Pathways.

What the NO PAIN Act Means for ASCs

Here's what to expect on this week's episode. 🎙️

Matthew Obenhaus is SVP of Design & Engineering at NueHealth, where his work spans product development, artificial intelligence, and direct surgery center operations.

Matt joins us for the next installment of our Trust the Data series to explain how ASCs can move beyond high-level dashboards and use artificial intelligence to turn their data into practical action.

We discuss how AI can help surgery centers analyze physician utilization, block time, projected revenue, case profitability, payer performance, and supply costs. Matt also explains how ASC teams can create repeatable workflows without traditional coding skills, identify potential data-quality issues, and reach useful insights faster.

Just as importantly, Matt shares why accurate data and human validation remain essential before presenting findings to physicians or board members. We also cover protecting PHI, establishing clear standards for AI use, and creating appropriate governance around these tools.

In our news segment, we cover a new forecast projecting significant ASC volume growth over the next decade, preview the return of HST Connect, and share a heartwarming story about a pediatric surgeon helping children feel like superheroes before surgery.

Resources Mentioned:

Matthew Obenhaus and NueHealth
https://www.nuehealth.com/insights/leadership/matt-obenhaus/

Vizient Forecasts Continued Growth in ASC Volume
https://www.ascfocus.org/ascfocus/news/digital-debut/202607-vizient-forcasts-continued-growth-in-asc-volume

HST Connect
https://www.hstpathways.com/connect/

Helping Children Feel Like Superheroes Before Surgery
https://www.businessinsider.com/superhero-costumes-help-kids-before-surgery-2026-8

Brought to you by HST Pathways.

How ASCs Can Use AI to Turn Data Into Action

Here's what to expect on this week's episode. 🎙️

We’re kicking off a short series called Trust the Data by sharing an excerpt from a recent webinar we hosted for our referral partners.

During the presentation, Ryan walks through findings from HST’s most recent State of the ASC Industry Report. The report brings together three years of benchmarking data from 682 surgery centers across 45 states and nearly 4.8 million cases.

The presentation explores six emerging trends shaping ASC performance, including uneven revenue cycle improvement, underused operating room capacity, patient collection leakage, gaps in accounts receivable follow-up, the efficiency of smaller centers, and the impact of specialty mix on growth and profitability.

After the presentation, Ryan covers CMS’s proposed 2.4% average ASC payment update for 2027 and explains why high-volume procedures could still receive lower reimbursement. He also looks at congressional proposals that could bring new price transparency requirements directly to surgery centers.

The episode closes with the uplifting story of three young heart transplant patients whose friendship helped carry them through nearly yearlong hospital stays.

Resources Mentioned:

2026 State of the ASC Industry Report:
https://www.hstpathways.com/resources/surgery-center-industry-report/

ASCA Analysis of the 2027 Proposed Payment Rule:
https://www.ascassociation.org/asca/news-and-publications/news/2026/2027-proposed-payment-rule

ASC Price Transparency Coverage:
https://www.beckersasc.com/asc-news/senate-committee-advances-price-transparency-bill/

Patients Deserve Price Tags Act:
https://www.congress.gov/bill/119th-congress/senate-bill/2355/text

House Energy and Commerce Committee Announcement:
https://energycommerce.house.gov/posts/the-house-committee-on-energy-and-commerce-advances-17-bills-to-the-full-house-of-representatives

The Power of Friendship Helps Three Young Patients Through Heart Transplants:
https://www.aha.org/tellingthehospitalstory/stories/power-friendship-helps-three-young-texas-childrens-hospital-patients-through-heart-transplants

Brought to you by HST Pathways.

Six Emerging Trends Shaping ASC Performance

Here's what to expect on this week's episode. 🎙️

Dr. Brian Cohen, practicing anesthesiologist and founding member and administrative chief of Miami Anesthesia Services, and Lee Kortmansky, Site Administrator at Physician Outpatient Surgery Center, join Grant Duncan to discuss one of the biggest issues facing ASCs right now: anesthesia subsidies and coverage. They break down how anesthesia costs often reveal deeper operational issues around scheduling, OR utilization, staffing models, room flipping, surgeon relationships, patient collections, and case profitability. Lee also shares how his center worked with Dr. Cohen’s team to reduce anesthesia subsidy exposure by nearly $300,000.

In our data segment, we connect the conversation to our 2026 SOTI report and highlight what ASC leaders can learn from block utilization, cancellation rates, patient collections, and case profitability benchmarks.

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

Brought to you by HST Pathways.

How ASCs Can Reduce Anesthesia Subsidy Pressure

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

Sean Hartzell is a Managing Director at VMG Health, where he advises healthcare organizations on strategy and capital planning. Sean joins us this week to break down how ASC leaders should think about funding growth. He walks through the key differences between debt and equity, how to calculate the “true” cost of major investments beyond the upfront price, and what factors can make or break a new initiative.

In our data segment, we’re talking all about spine. Spine is being called one of the fastest-growing ASC service lines, driven by a combination of CMS policy changes, payer pressure, and continued advancements in minimally invasive techniques. We’re going to spend the episode focusing specifically on spine ASCs and the potential opportunity for growth based on data-driven insights.

Resources Mentioned:

HST’s Specialty Data Report: Spine [https://www.hstpathways.com/specialty-data/spine]

Brought to you by HST Pathways.

Should You Make That Investment?

Jon Vick is the Founder and Principal of ASC Realty Advisors, where he has spent decades advising physicians and ASC operators on healthcare real estate strategy. Jon joins us this week to explain how ASC sale-leasebacks work and why they are becoming an increasingly relevant strategy for physician owners. He walks through how centers can use sale-leasebacks to fund de novo projects, expansions, and renovations without taking on additional debt, while also addressing common concerns around control and long-term value.

In our data segment, we’re discussing OR block utilization and showing how increased usage can generate millions in revenue. We’ll use real podiatry stats as an example, but the same concept and tips apply to any specialty.

Resources Mentioned: https://www.hstpathways.com/specialty-data/podiatry

Contact Jon + his team: https://www.ascrealtyadvisors.com/about/leadership/

Brought to you by HST Pathways.

How ASC Sale-Leasebacks Work 

Stephanie Tarry brings more than three decades of experience in the ASC industry. Now with Physician Transaction Advisors, she works closely with physician groups to evaluate partnership opportunities and guide them through the transaction process from start to finish. In this episode, she breaks down how ASC transactions actually unfold, from early readiness and confidential information memorandums to letters of intent, quality of earnings, and closing.

In our data segment, we’re breaking down Case Share by Age Group from HST’s demographic benchmarking report. If you’re not tracking your age mix, you may be missing a key component of what is truly driving demand and financial performance at your ASC. There is a direct correlation between age and specialty, which means there is a secondary correlation between your patient’s age and potential revenue.

Resources Mentioned: https://www.hstpathways.com/specialty-data/asc-demographic-data

Brought to you by HST Pathways.

Inside the ASC Deal Process: From LOI to Close 

This Week In Surgery Centers (@hstmarketing) · Zencastr

This Week In Surgery Centers (@hstmarketing)

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.