ASCs surge as hospitals and investors chase outpatient growth

Editor's Note

Hospitals, physicians, and private equity are accelerating their push into lower-cost outpatient care. According to Colliers US Healthcare Services Research Report Q3 2025, published on September 22, ambulatory surgery center (ASCs) procedure volumes are projected to grow 9% between 2023 and 2028—outpacing hospital outpatient department growth at 7%—and revenues are expected to climb from $45 billion in 2024 to $57 billion by 2030.

The report attributes this momentum to technological innovation, policy shifts, and consumer demand for accessible, affordable care. ASCs offer hospitals new profit streams while expanding patient access and easing inpatient capacity pressures. The report highlights that site-neutral payment policies and minimally invasive techniques are driving more procedures to outpatient settings. On average, ASC procedures cost less than half as much as those performed in hospitals, saving Medicare an estimated $4.2 billion annually and consumers roughly $684 per case.

Hospitals are increasingly adopting ASCs as a strategic growth platform. The number of centers managed by national operators jumped from 1,339 in 2011 to 2,140 in 2024, with most owned or co-owned by physicians. Growth is concentrated in high-margin specialties such as cardiology and spine surgery, while traditional ASC services like colonoscopy and cataract removal yield lower returns.

Per the outlet, workforce shortages—particularly among anesthesiologists—remain a constraint, while certain specialties, including dermatology and ophthalmology, are shifting select procedures into office-based settings. At the same time, expanded Medicare and Medicaid reimbursement for ASC procedures is boosting utilization, especially among the aging Baby Boomer population, which will make up 20% of US residents by 2030.

Consolidation continues to reshape the sector. In June 2025, Ascension Health agreed to acquire AmSurg for nearly $3.9 billion, adding 250 ASCs across 34 states. Tenet Healthcare’s United Surgical Partners International also plans to invest $250 million annually in new ASC joint ventures. Private equity remains a major force, with $18.9 billion invested through the first half of 2025, following a $19.7 billion rebound in 2024.

As Colliers concluded, the “consumerization” of healthcare is steering the ASC boom, as patients now expect high-quality, convenient, and insurance-friendly care close to home.