The first ASC in the United States opened in 1970 and explosive growth happened through the late 1980s and into the 1990s, according to the Ambulatory Surgery Center Association (ASCA). ASC growth has been steady over the past two decades, with more than 5,800 ASCs performing an estimated 30 million procedures in 2020, the ASCA says.

Several factors are driving ASC growth, he says. "We see that there is an increasing movement of cases from the main hospitals into ASCs, mainly for increased safety for patients, profitability, removing costs from the health system, and better patient outcomes. Many surgeries that used to be thought to only be done in a main hospital can be done safely in a surgery center, which can be beneficial for physicians, health systems, and patients." says Alexander Sah, MD, co-director of the Institute for Joint Restoration and Research in Fremont, California.

ASCs benefit healthcare providers, patients, and payers, Sah says.

"For healthcare providers, ASCs are an opportunity to have more control over how things are done. In a main hospital, you have many resources at your disposal, but you also have the challenges of emergency cases as well as operating rooms that have a wide scope of procedures that they perform. In an ASC, there is an opportunity to fine-tune skills and develop very specific programs. For example, you can develop an orthopedic-specific ASC or another facility that has a narrow focus of care. In that way, you can have areas of excellence. You can have centers that focus only on hip and knee replacement. Those centers can fine-tune their protocols and processes so that patients can have more efficient and predictable surgeries and outcomes."

For patients, there are benefits in avoiding main hospitals, he says. "For elective surgeries, such as joint replacement, many patients do not want to go to a main hospital. They do not want to be in a building where there are ill people—they want to avoid infection risk or other complications. By avoiding exposures to potential risks in the main hospitals, patients can achieve better outcomes."

And compared to procedures done in main hospitals, ASCs have reduced costs, which benefits payers, Sah says.

Learn more about why ASC growth shows no sign of plateauing in this article.

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