If you’ve been looking for a clear, ASC-focused breakdown of the 2026 CMS final payment rule, this episode is for you. This week, ASCA’s Chief Advocacy Officer, Kara Newbury, joins us to break down the most important things ASC leaders should note coming out of the 1600+ page document (all in under half an hour). Kara takes us through the reimbursement rate, the weight scalar update and ASCA’s advocacy for its elimination, a major rate oversight on the most common ASC procedure, massive covered procedure list expansion, and more.

In our data segment, we look at patient payment behavior at ASCs and discuss some of the reasons why partial payments are rising and paid-in-full cases are declining, and how financial stress and insurance complexity are showing up in case cancellation rates.

Resources mentioned:

Ambulatory Surgery Center Association [https://www.ascassociation.org/home]

Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Final Rule [https://www.cms.gov/newsroom/fact-sheets/calendar-year-2026-hospital-outpatient-prospective-payment-system-opps-ambulatory-surgical-center]

HST Pathways 2024 State of the Industry Report [https://www.hstpathways.com/resources/surgery-center-industry-report/]

Brought to you by HST Pathways.

What to Know About CMS’s 2026 Final Rule for ASCs

If you only had time to do one thing this week to improve your surgery center, what should it be? 

To kick off the countdown to year-end, This Week in Surgery Centers pulls together a year’s worth of conversations into one rapid-fire episode, featuring input from 30 past guests on the closing question of every interview: what is one thing ASC leaders can do this week to improve their surgery centers? You’ll hear practical, do-it-this-week ideas from ASC administrators, nursing leaders, business office experts, consultants, and physicians on:

 * Supporting and recognizing your staff in meaningful ways
 * Cleaning up payer profiles, item masters, and days to bill to strengthen margins
 * Tightening credentialing, monitoring, disaster plans, and IT/infosec policies
 * Improving communication with patients, caregivers, schedulers, and surgeons
 * Getting your financials and partnerships ready for the next phase of growth

This episode gives you simple, concrete starting points to make 2026 a stronger year for your center — one small improvement, week by week.

Brought to you by HST Pathways.

2025 Highlights: 30 Guests on One Thing You Can Do This Week

In the third installment of our case costing series, HST Pathways’ Chief Innovation Officer, Gavin Fabian, breaks down what “mature” case costing actually looks like in a real ASC (and why, done right, it’s pretty boring). The conversation covers why so many initiatives fall apart at the cost-data level, how to clean up your item master and documentation workflows, and practical steps to move from retrospective spreadsheets to automated case profitability forecasting. Gavin also shares where AI can help plug data gaps, where forecasting should live in your scheduling workflow, and how to use these insights to drive surgeon alignment without sacrificing culture.

In the data segment, we discuss a custom metric from HST’s demographic benchmarking report: OR Minute–Case Gap (by Sex). You’ll hear how this metric is calculated from a 5.3 million–case dataset, what national patterns look like in specialties such as Cardiovascular and Spine, and how ASC leaders can use these insights to challenge assumptions about block times, staffing, and scheduling — so days run closer to plan..

Resources mentioned:

Who’s on Your Schedule? Demographic Trends and Benchmarks for ASCs [https://www.hstpathways.com/specialty-data/asc-demographic-data]

Who’s on Your Schedule? Exploring Demographic Data for ASCs (Podcast) [https://youtu.be/NFoBXHO0V_g?si=ZPxoSxLpxnqzS6Yw]

HST Pathways 2025 Client Award Nominations [https://www.hstpathways.com/client-awards/]

Brought to you by HST Pathways.

From Case Costing to Profit Forecasting

In this week’s episode, the second installment in our case costing series, Grant Duncan sits down with VMG Health’s Vanessa Sindell and Nancy Stephens to unpack the unsung hero of accurate case costing: a clean inventory master. They cover practical, do-it-today tactics like using naming conventions that work at the point of care, leveraging GPO data to understand all of your pricing options, and keeping preference cards current, so cost-per-case is surgeon ready. They also make the case for dedicating an FTE to the process to maximize cost savings.

In the news: the still-pending OPPS/ASC final rule, the implications of CMS site-neutrality efforts, a new analysis drawing scrutiny to UnitedHealthcare’s payments to Optum-employed physicians compared with market peers, and encouraging results for a multi-cancer blood test showing high detection accuracy alongside standard screening.

Resources Mentioned:

VMG Health [https://vmghealth.com/]

CMS’ delayed ASC rule release, explained [https://www.beckersasc.com/asc-news/cms-delayed-rule-release-explained/] (Becker’s ASC Review)

CMS’ site-neutral reform poised to upend hospital-ASC dynamics [https://www.beckersasc.com/asc-coding-billing-and-collections/cms-site-neutral-reform-poised-to-upend-hospital-asc-dynamics/] (Becker’s ASC Review)

Study suggests UnitedHealthcare pays Optum docs more than other providers [https://www.fiercehealthcare.com/payers/study-suggests-unitedhealthcare-pays-optum-docs-more-other-providers] (Fierce Healthcare)

A simple blood test can detect 50 types of cancer: We explain [https://www.usatoday.com/story/graphics/2025/11/09/cancer-blood-test-dna-galleri/87126236007/] (USA Today)

Brought to you by HST Pathways.

Case Costing: Creating a Clean Inventory Master

This week’s guest, Melissa Rice, is the administrator at Loyola Ambulatory Surgery Center at Oakbrook Terrace (part of Trinity Health), and the newly elected Illinois Ambulatory Surgery Center Association President. In the first episode of our Case Costing series, Melissa lays out a practical playbook that changes behavior — how to pull the levers that drive profitability (implants, supplies, staffing), why clean data must come first, how subspecialty data can surface margin-wrecking outliers, and the right way to align your staff, surgeons, vendors, and your board using clear numbers and transparent governance.

In our data segment, we spotlight the Days to Bill benchmark — which rose to 4.4 days on average in 2024 from 3.6 in 2023 — and a few specialty-specific improvements. We talk about why this metric matters, what it can indicate, and a few simple ways to accelerate cash while mitigating denial risk.

Resources mentioned:

HST Pathways State of the Industry Report [https://www.hstpathways.com/resources/surgery-center-industry-report/]

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

HST Pathways Cardiovascular Specialty Data Report [https://www.hstpathways.com/specialty-data/cardiovascular]

HST Pathways Gastroenterology Specialty Data Report [https://www.hstpathways.com/specialty-data/gastroenterology]

Brought to you by HST Pathways.

The 3 Case Costing Levers: Implants, Supplies & Staffing

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.

Live from New York: Perspectives from a Surgeon, an ASC Leader & a Policy Expert

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.

Who's on Your Schedule? Exploring Demographic Data for ASCs

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.

AI in Action: Improving OR Utilization at Beverly Hills ASC 

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.

ASC Market Brief: Policy, People, and the Path to 2026

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.

Improving the Patient Experience: Best Practices for Pre-Assessment Workflows 

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

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