8 Critical Challenges Facing Ambulatory Surgery Centers (ASCs) in 2026 and Beyond

Key ASC Challenges in 2026 and Beyond

• Rising operational costs (identified by 31.3% as top challenge) combined with shrinking reimbursements create a margin squeeze - expenses jumped 9% in 2024 while you're paid a fraction of hospital rates

• Staffing crisis threatens operations with nearly 50% of healthcare leaders planning to leave and ASCs unable to match hospital compensation for nurses and techs

• Credentialing delays averaging 150 days can cost $30,000 weekly per waiting physician, while billing challenges and constant code updates fuel claim denials

• Supply chain disruptions persist with year-long equipment waits and inflated costs for basic supplies like masks and gloves

• Documentation and compliance burdens keep growing despite reduction goals, with EMR integration gaps and stricter CMS oversight adding administrative weight without additional resources

Rising Operational Costs: The Budget Crisis Hitting Every ASC

Money troubles top the list for good reason.

31.3% of ASC operators say rising costs are their biggest headache right now - more than any other challenge.

The numbers tell a sobering story: operating expenses shot up nearly 9% in 2024, with each physician now costing facilities over $1.1 million annually in direct costs alone.

Healthcare inflation just hit a 23-year high of 4.6%, and you're feeling it everywhere.

Your salary expenses keep climbing as you fight to retain staff.

Medical supplies and drugs - those essential line items you can't skimp on - are eating bigger chunks of your budget as pandemic-related price hikes persist.

Meanwhile, reimbursement rates aren't keeping pace, squeezing your margins from both sides.

Why Can't We Keep Good Staff? The Talent Retention Emergency

One in four ASCs calls staffing their greatest challenge, and the situation looks grim.

Nearly half of healthcare leaders plan to jump ship within the next year.

You're not just losing people - you're stuck in an expensive bidding war you can't win.

Hospitals outbid you for registered nurses with fatter paychecks, signing bonuses, and benefits packages you can't match.

Surgical technologists get poached by larger systems offering the same perks.

The burnout runs deeper than money though.

Your staff describes feeling "moral injury" - they spend more time documenting than actually caring for patients.

The irony?

Research shows proper onboarding increases retention by 82%, yet work-life balance for physicians remains the worst across all careers.

When your team feels perpetually overwhelmed, even the best onboarding won't keep them around.

Reimbursement Rates Continue Their Downward Spiral

Here's the painful reality: your reimbursement is designed to be a fraction of hospital payments.

Insurance companies save money by steering outpatient surgeries your way, but you bear the cost burden.

12.5% of ASCs rank this as their top challenge.

The CMS 2025 updates make things more complicated.

You now need to prove quality metrics to maintain profitability under value-based care models.

Bundled payments mean you're taking on more risk.

The shift demands new strategies just to maintain current revenue levels, let alone grow.

The Credentialing Bottleneck Costing Thousands Weekly

Credentialing can bleed you dry before a provider sees their first patient.

The process stretches up to 150 days, and the math hurts: with orthopedic cases averaging $3,719 each, losing eight cases weekly means $30,000 down the drain per physician waiting for credentials.

The paperwork alone is overwhelming - NPI numbers, CVs, state and DEA licenses, board certifications, liability insurance, peer references, and CME documents.

International providers face even longer waits.

As you grow and add providers, the backlog worsens.

Each payer wants different requirements, multiplying your administrative burden.

No wonder the credentialing software market is exploding from $1.3 billion to a projected $5.6 billion by 2030 - everyone's desperate for solutions.

Billing Challenges and Claim Denial Nightmares

Your billing team fights denials daily - wrong codes, missing documentation, sudden policy changes.

Getting paid shouldn't be this hard.

Ideally, your Days in A/R stays between 30-40 days, never exceeding 50.

But that's tough when you're juggling constant code updates.

In 2018 alone, you had to track 170 new CPT codes, 60 rewrites, and 82 deletions.

ICD-10 codes change every October.

Miss an update, and denials pile up.

The scrutiny keeps intensifying too.

CMS watches your documentation like a hawk, ready to reject claims or trigger audits over the smallest compliance slip.

When Prior Authorization Becomes a Revenue Killer

Prior authorization delays directly hit your bottom line.

Stricter regulations mean procedures get postponed and revenue disappears.

You need proactive tracking systems just to stay afloat.

Some ASCs turn to automated software and EHRs to streamline authorizations, but even then, the administrative burden remains heavy.

Supply Chain Disruptions and Equipment Delays

Supply problems haven't disappeared.

You're still dealing with shortages and limited availability of critical supplies.

One ASC waited over a year for sterilization equipment - imagine operating without that.

The essentials you need daily - N95 masks, gloves, alcohol, eye protection, gowns - cost more as inflation drives up medical inventory prices.

Smart ASCs are building flexible supply chains and strengthening purchasing power through broader supplier networks, but adaptation takes time and resources you might not have.

The Documentation and Compliance Burden

Despite aims to reduce documentation burden by 75% by 2025, the paperwork keeps growing.

You're juggling five burden domains: reimbursement, regulatory, quality, usability, and self-imposed requirements.

Accreditation brings stricter regulations - surveyors demand specific documents on specific dates.

Your EMR probably doesn't integrate smoothly with other systems, adding manual work to every case.

CMS compliance is non-negotiable; slip up and face penalties, rejections, and audits.

The administrative weight keeps growing while your resources stay flat.

What If Patient Communication Wasn't Another Daily Battle?

You're fighting eight major challenges that threaten your ASC's survival.

Between credentialing delays costing $30,000 weekly and half your staff planning exits, you need solutions that actually work.

Dialog Health's HIPAA-compliant texting platform lightens your load instead of adding to it.

While battling staff shortages, our automated two-way texting eliminates hours of phone calls - one center saw 92% fewer post-operative calls.

Another achieved 53% reduction in no-shows, recovering lost revenue from those mounting operational costs.

The results speak for themselves:

• 66% decrease in same-day cancellations

• 82% reduction in readmissions within 90 days

• $100,000 revenue increase from reducing no-shows by 34%

• 95% reduction in emergency phone calls

Here's what happens next: Fill out this quick form and one of our healthcare communication experts will reach out to schedule a brief 15-minute video call at your convenience.

We've done this hundreds of times with ASCs just like yours - no pressure, just answers.