Orthopedics is all in on ASCs: Here’s why

Why are so many orthopedic groups going all-in on ambulatory surgery centers?

Orthopedic practices know a thing or two about efficiency. Precision, predictability, and scale have been their playbook for decades. Whether it’s managing high volumes of joint replacements or coordinating intricate spine procedures, these teams have long relied on systems that deliver consistent outcomes and sustainable growth.

Given that, it’s no surprise orthopedic leaders have become some of the most committed adopters of ambulatory surgery centers (ASCs). From a patient care, financial, and operational perspective, ASCs just make sense.

As more procedures migrate out of hospital settings, orthopedic groups are turning to ASCs as a smarter, more scalable way to deliver care and build long-term practice value. And they’re doing it through a variety of structures. Some practices are building their own centers. Others are partnering through joint ventures, MSAs, or private equity-backed networks. Whatever the structure, the goal is the same: more control, stronger margins, and a better patient experience.

Let’s break down why orthopedic ASCs are gaining momentum and why that trend is only building.

Orthopedic procedures fit the ASC model (almost too well)

Orthopedics is built for scale, and ASCs are built for efficiency. It’s a natural strategic match.

With surgical advances in minimally invasive techniques, regional anesthesia, and improved post-op pain management, many orthopedic procedures that once required hospital stays can now be safely performed in outpatient settings. Total joint replacements, arthroscopies, and even select spine surgeries are routinely performed in these outpatient facilities. Regulatory and reimbursement trends support this move, with CMS and commercial payers actively encouraging the shift.

For instance, CMS removed dozens of procedures from the inpatient-only list, and payers are pushing to redirect high-cost orthopedic cases out of hospitals when clinically appropriate.

Additionally, many orthopedic organizations don’t just perform surgical cases. They’re managing complex pain management care, too. Think spinal injections, nerve blocks, radiofrequency ablation — all reimbursable, and all ASC-ready.

Integrating both surgical and pain management services into a single ASC strategy allows for tighter scheduling, more coordinated care, better resource utilization and revenue capture without the need to expand your footprint or staff unnecessarily.

More control. Better margins. Fewer headaches.

Hospitals haven’t always made life easy for orthopedic surgeons. Block times get bumped. Input on staffing? Minimal. The rising facility fees? Hard to ignore. It often feels like operating on someone else’s terms.

ASCs flip that dynamic. Whether a group builds its own center, partners with one, or affiliates with a broader network, the model offers more direct control over scheduling, equipment, staffing, and, most importantly, the patient experience. This autonomy can lead to faster case flow, improved coordination, and better outcomes across the board.

And yes, there are clear financial benefits. Ownership or equity stakes in an orthopedic ASC opens new revenue streams, including a share of facility fees that aren’t available in traditional hospital-based settings. For practices feeling margin pressure from fee-for-service rates or value-based contracts, ASCs offer a buffer. One that can stabilize margins and support reinvestment into growth initiatives.

ASCs aren’t a side project — they’re a strategic move for orthopedic groups toward more control, stronger margins, and a better patient experience.

Patients are driving demand for ASC-based care

Patients want convenient, comfortable, and affordable care. ASCs offer all three. Shorter check-in times, focused care environments, quicker discharges, and the comfort of recovering at home make a real difference.

Then there’s the cost. In most cases, out-of-pocket savings at ASCs are significant compared to hospital outpatient departments. That price transparency and affordability aren’t lost on patients or referring providers seeking high-quality, value-conscious care partners.

Ultimately, it’s not just about delivering care, it’s about shaping the full patient experience. Fewer handoffs, more personalized care, and a smoother clinical journey all contribute to higher satisfaction. That satisfaction, which tends to be higher for ASC-based care, drives loyalty, retention and a stronger reputation in the community. These are key assets for any organization looking to grow its market share.

Turning ASCs into a growth advantage with the right strategy

Thinking about building or joining an ambulatory surgery center? Great choice. Across the country, orthopedic organizations are making this move and reaping the rewards, but success hinges on preparation and alignment.

Operational excellence is critical. Beyond physical infrastructure, practices need the right staffing model, payer strategy, and technology foundation to run efficiently. Data analytics and clear visibility into patient volume, case mix, and resource needs are essential for aligning clinical workflows with business performance.

Experienced partners who know both sides of the equation (clinical and administrative) can make this process more manageable. That includes EHR vendors, billing partners, and data teams who’ve done this before. With deep roots in both the ambulatory and orthopedic spaces. They can help navigate the transition more effectively and with better long-term results.

Building or joining a surgery center is not simply about having a facility. It’s about operating it with intention, backed by systems and strategies that support high performance and scalability.

What comes next for orthopedic leaders?

ASCs aren’t a future consideration; they are a present-day driver of change in orthopedic care. Practices that embrace this shift now are setting themselves up for success.

For administrators and physician leaders, the ASC path is not only viable; it’s becoming essential for thriving in modern healthcare. While there’s no one-size-fits all model, the trend is clear: more cases are leaving hospitals, patients are seeking more convenient care, and margins are tighter than ever. If you're not actively planning your ASC strategy, now is the perfect time to get started.

Need a starting point? Take a look at The Rapid Rise of ASCs and What ASCs Need to Thrive in 2025 for a deeper look at what’s working and what to watch out for.

And stay tuned, athenahealth is applying what we’ve learned in ambulatory care to support the ASC space, beginning with orthopedics and pain management practices ready to take the next step.