The 3 Biggest Pressures ASC Administrators Are Dealing With Right Now — And What's Actually Driving Them

If you run or manage an Ambulatory Surgery Center, you already know this: things feel harder than they used to. It’s not just one issue — it’s a combination of pressures hitting at the same time: costs are going up, staffing is tighter, and surgical cases are getting more complex.

Most surgery centers aren’t doing anything wrong. But many of the systems behind the scenes — especially surgeon preference cards — haven’t kept up. When you break it down, most of what administrators are dealing with today falls into three areas.

1. Financial Pressure: Margins Are Getting Tighter and Less Predictable

Reimbursement hasn’t kept pace with rising costs — and the gap is becoming harder to absorb. CMS finalized only about a 2.6% payment increase for ASCs in 2026, while supply chain costs and labor continue to rise. At the same time, ASCs are still reimbursed significantly less than hospital outpatient departments for similar procedures, reinforcing long-term margin pressure.

And expenses aren’t slowing down. Healthcare operating costs — including surgery supplies and staffing — continue to climb, with medical supply chain costs projected to rise again in 2026. Salaries, wages, and benefits alone can account for 20–30% of an ASC’s net revenue.

For most administrators, that creates a familiar challenge: you’re expected to protect margins in a system where your largest cost inputs — labor and supplies — are trending upward.

And supply costs, in particular, are harder to control than they appear. Variation between surgeons, limited visibility into item-level cost, and lack of standardization all contribute to higher per-case spend. Even when two surgeons perform the same surgical procedure, the underlying supply cost can differ significantly based on preference and product selection.

Where PREFcards Fits

PREFcards helps make supply cost variation visible — and actionable. Instead of relying on static lists, administrators can:

• Compare cost differences across surgeons performing the same procedure
• Identify where supply variation is driving higher case costs
• Track cases that consistently run over expected supply cost

And importantly:

• View item-level pricing directly within surgeon preference cards
• Build equivalency lists for supplies, giving teams visibility into alternative products, cost differences between options, and lower-cost substitutes that meet the same clinical need

This allows for more informed decision-making at both the clinical and administrative level — without disrupting surgeon autonomy. It also supports more productive conversations between surgeons, supply chain teams, and administrators.

The goal isn’t to force standardization — it’s to make cost differences clear enough that better decisions become easier.

2. Operational Strain: The Work Hasn’t Changed — But the Margin for Error Has

Staffing challenges are one of the most visible issues in ASCs right now. In a recent industry survey, 25% of ASC leaders identified staffing constraints as their single greatest challenge, second only to rising costs. And more than 31% said rising operational costs were their top concern, showing how closely these issues are tied together.

At the same time, administrators are dealing with a workforce that is harder to recruit and retain:

• ASCs must compete with hospitals offering higher salaries and benefits
• Demand for skilled roles like nurses and surgical techs continues to outpace supply

But what teams feel day to day isn’t just staffing — it’s friction. When systems aren’t reliable, the workload increases: more double-checking, more workarounds, more time spent preparing for each case. And those small inefficiencies add up quickly.

Where PREFcards Fits

The biggest shift here is making physician preference cards something staff can rely on. Standardized, digital preference cards reduce variability, and staff don’t have to rely on memory or informal notes.

But the difference shows up most in the room, with built-in images and visual guidance — staff can see exactly how setups should look, including mayo stand configuration and other operating room setup details. That directly impacts:

• Faster setup times
• Higher nurse and scrub tech confidence
• More consistency across teams and shifts

It’s especially valuable for new hires, float staff, and teams working with unfamiliar surgeons. Over time, preference cards also become training tools, not just reference documents.

Operationally, PREFcards also provides reporting visibility into which cases or surgeons consistently run over time — and by how much. That gives administrators something concrete to improve — not just anecdotal feedback.

3. Strategic Complexity: Growth Is Happening — But It’s Getting Harder to Manage

ASCs are growing — but that growth comes with new challenges. The industry now includes 6,500+ Medicare-certified ASCs and over 18,000 operating rooms, with continued expansion expected. At the same time, outpatient volume is projected to increase significantly over the next decade, with more complex surgical procedures shifting into ASCs.

That growth creates opportunity — but also pressure. Administrators are being asked to make decisions about:

• Surgical block time allocation
• Case mix
• Service line growth
• Surgeon performance

And those decisions are harder when visibility is limited.

Where PREFcards Fits

PREFcards helps connect the dots between volume, cost, time, and reimbursement. That allows administrators to:

• Compare surgeon performance across cost, efficiency, and margin
• Track case volume trends over time
• Understand how OR time aligns with financial return
• Identify where standardization can improve performance

Instead of relying on lagging reports, you get a clearer view of what’s actually happening — and where to focus.

Why This Matters More Than It Seems

Most facilities don’t have “bad” systems. They have systems that were good enough — but haven’t kept up with new demands. And as pressure increases — from healthcare supply costs, staffing, and growth — those gaps become more visible.

Final Thought

ASC administrators today are being asked to do something difficult: run tighter operations, with fewer resources, in a more complex environment. The challenge isn’t identifying the problems — it’s having the visibility to fix them.

When surgeon preference cards are accurate, structured, and connected to real data, they stop being static documents — and start becoming part of how the ASC actually runs.

Book a demo to see how PREFcards gives your ASC that visibility.

---

Sources

1. Centers for Medicare & Medicaid Services (CMS). Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Fact Sheet.
2. ASC News. From Budget Bleed to Burnout: The Top ASC Challenges Defining 2025, 2025.
3. HST Pathways. State of the ASC Industry Report.
4. SIS First. Ambulatory Surgery Center Statistics That Define the Industry.
5. Outpatient Surgery Magazine (AORN). ASCs Face Fresh Challenges as the Market Evolves.