Picture this: a skilled surgeon has decades of experience in their specialist field and a long track record of making the crucial decisions that save lives. But they’re heading into surgery without a full patient history or anywhere near an acceptable understanding of what caused the patient’s rapidly deteriorating condition. Seem unlikely?

Ambulatory surgery centers (ASCs) have diverse processes to navigate, from front-end tasks such as collecting demographic information and verifying insurance, to coding and billing compliance in an ever-changing regulatory environment. In the complex world of surgical revenue cycle management (RCM), both standalone and hospital-affiliated ASCs need a comprehensive RCM solution to achieve peak financial performance and operational excellence.

House Republicans have proposed sweeping changes to healthcare policies and other federal programs, marking a significant shift in priorities under President Donald Trump. 

Many ASCs across the U.S. are seeing patient copays increase for outpatient surgery, and collecting upfront from patients is tough. But it's necessary to keep the ASC running smoothly.

On Nov. 1, CMS finalized a 2.83% physician pay cut for its 2025 Medicare hospital outpatient prospective payment system and ASC payment system, marking the fifth consecutive year of cuts to physician reimbursements. 

Here are what three ASC leaders told Becker's they see coming down the pipeline as procedures continue to migrate from the hospital to ASC setting in 2025.

The healthcare industry is entering a transformative era as major legal and regulatory frameworks, including the Stark Law, face significant updates and reinterpretations.

Aetna has filed a lawsuit against Radiology Partners and Mori, Bean and Brooks, RP's Jacksonville, Fla.-based affiliate, alleging a fraud scheme that resulted in overpayments totaling tens of millions of dollars, according to court documents obtained by Becker's. 

In 2024, major developments in insurance and healthcare policies have sparked significant changes affecting ASCs and physicians. 

Here are five numbers for ASC leaders and physicians to know about prior authorization in 2024:

Oroville (Calif.) Hospital agreed to pay $10.25 million to resolve false claims allegations stemming from medically unnecessary inpatient hospital admissions, a kickback and physician self-referral scheme and erroneous diagnosis code use.

Here are 26 moves by payers for ASC leaders and physicians to know in 2024:

Here are three recent updates on prior authorization for ASC physicians and leaders to know:

On Nov. 26, CMS proposed reforms to the Medicare Advantage and Part D programs for contract year 2026, including changes to prior authorization and GLP-1 coverage. 

ASCs are facing a trifecta of pay issues — anesthesia stipends, rising expenses and stagnant reimbursements. 

Many ASCs have voiced support for site neutrality, which would create parity between ASC and hospital reimbursements, yet has been met with pushback from hospitals. 

The ASC market will likely see significant growth into the next several years, but many ASC leaders and physicians continue to feel tied down by arduous administrative burdens. 

ASC software leader Surgical Information Systems has acquired ASC-focused, revenue cycle management, transcription and coding services provider Surgical Notes. 

While many physician specialties have seen salary increases in recent years, those increases are being felt less by physicians. 

During an interactive session at Becker's 30th Annual meeting: The Business & Operations of ASCs, Dan Parsons, Co-Founder and Chief Experience Officer at Thoughtful AI, and Kathrynne Johns, Chief Financial Officer at Allegiance Mobile Health, discussed the implementation and benefits of AI in revenue cycle management.