Digital Debut

Avanza Survey Shows Hospital Commitment to ASC Growth

Ninety percent of those surveyed plan to increase surgery center affiliations

MAY 23, 2025

Hospital and health system ownership in surgery centers continues to rise sharply, according to Avanza Strategies’ 6th Avanza Intelligence Hospital Leadership ASC Survey, which was released on May 14. More than 80 percent of hospital systems reported in the survey that they own at least one ASC; in 2019, only 41 percent of hospital systems reported they owned a surgery center.

The survey gathered insights from 101 hospital and health system leaders, including chief executive officers, presidents, board members, and clinical, financial and operations executives. Their responses reflect a growing consensus that ASCs have become integral to hospitals’ and health systems’ long-term outpatient strategy.

Ninety percent of hospitals and health systems say they plan to increase ASC affiliations and development. While physician joint ventures remain the dominant model, with about 75 percent of respondents indicating that they are structuring their ASCs as joint ventures, hospital systems are increasingly seeking majority ownership. According to the survey, physicians might be more receptive to this model expecting more autonomy, and hospitals appear increasingly willing to give physicians operational control while maintaining oversight in other areas.

“ASCs have firmly established themselves as a cornerstone of modern healthcare, delivering top-tier outcomes and exceptional patient satisfaction,” said Steve Mason, president of Avanza, in a release. “As more surgeries move out of inpatient settings, hospitals and health systems are turning to ASCs to expand access, reduce costs and stay competitive in a rapidly evolving landscape.”

The survey found that hospitals and health systems are looking to build a surgery center portfolio, with 57 percent of respondents stating that their organization owned two or more ASCs. The pursuit of ASCs by hospitals and health systems is being driven by several factors, including the need to expand outpatient surgical capacity, strengthen physician relationships, meet rising consumer demand, respond to relaxed certificate of need regulations and address growing pressure from commercial payers to reduce costs. The survey also highlights a growing preference for internal ASC management, with more than half of hospitals and health systems reporting that they now manage their centers in-house, often with external advisory support and services.

“It comes as no surprise to see our new survey indicate that hospitals and health systems are expanding their ASC networks to meet growing demand from payers, physicians and patients for high-efficiency, cost-effective surgical care,” said Joan Dentler, founder of Avanza, in the release. “Many are moving beyond a single ASC, strategically increasing their footprint to align with evolving surgical needs and market dynamics.”