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 

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.

Improving the Patient Experience: Gramercy’s Patient-First Culture & New York’s ASC Momentum

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.

Improving the Patient Experience: Clinic and ASC Communication

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.

Anesthesia: Driving Surgical Volume

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.

Anesthesia: Building an In-House Team 

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.

The CMS 2026 Proposed Payment Rule for ASCs

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.

Maximizing OR Utilization in Ortho ASCs

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.

The 8-Step Software Evaluation Checklist

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.

Highlight Reel – 15 Tips to Improve Your Surgery Center 

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!