With more complex spine and orthopedic surgeries moving to the ASC setting, physician leaders are predicting continued growth — but caution that economic and policy shifts could slow the trend.
Four spine and orthopedic leaders recently shared their respective outlooks with Becker’s.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Looking ahead three to five years, what’s one bet you’re making about the future of spine or orthopedic care in the ASC setting, and what might derail it?
Leslie Jebson. Regional Administrator at Prisma Health (Greenville, S.C.): The five-year horizon for outpatient spine and orthopedics will continue to experience significant growth, estimated at 8% to 10% from 2025 to 2030. As the population ages, the prevalence of musculoskeletal conditions — from degenerative shoulder issues to herniated discs — will drive demand for innovative, minimally invasive surgical solutions. Key growth drivers will include artificial intelligence in imaging, robotics in surgical planning and intraoperative care. However, rising workforce, supply and technology costs will challenge sustainability, requiring healthcare systems to rethink how care is coordinated across sites.
Jared Travis, BSN, RN. Administrator of Oxford (Miss.) Surgery Center: I expect to see a significant acceleration in the shift of complex spine procedures to the ASC setting, fueled by advances in minimally invasive and endoscopic techniques, robotic-assisted surgery and enhanced recovery protocols. This movement is supported by payer pressure, patient preference for lower-cost care and surgeon alignment with physician-owned models. The biggest risk is tightening reimbursement from commercial payers. If rates fail to cover technology, staffing and compliance costs, ASCs may limit case complexity or delay innovation.
Brian Curtin, MD. Orthopedic Surgeon at OrthoCarolina (Charlotte, N.C.): Complex spine and higher-acuity orthopedic cases will keep moving to ASCs as anesthesia protocols and postoperative pain management improve. Payer pressure will continue to push cases to ASCs, and patients increasingly prefer outpatient settings over hospitals. Economic challenges — particularly unsustainable reimbursement from CMS or commercial payers, along with high capital and staffing costs — could slow this shift and push expensive cases back to hospitals.
Shobhit Minhas, MD. Orthopedic Surgeon at Fox Valley Orthopedics (Geneva, Ill.): Orthopedic case volume and complexity will continue to grow in ASCs, driven by CMS phasing out the inpatient-only list, possible site-neutral Medicare payments and ASC reimbursement increases. Surgeon preference, ownership models and patient demand for lower-cost, high-quality care will further accelerate the shift. Potential derailers include reduced Medicare reimbursement that fails to keep pace with inflation and complications from pushing the boundaries of safe outpatient care, which could undermine trust in ASCs.
