Double Digit Growth Expected for Ambulatory Surgery Centers

November 6, 2023
Surgeon passing over surgical tool and surgical light in background
Ambulatory surgery centers (ASCs), and outpatient surgeries in general, are projected to see double digit growth over the next decade, according to “2023 Impact of Change® Forecast” from Sg2, a Vizient company. Vizient is a Provista contracting partner. Outpatient surgical volumes are expected to experience an 18% increase to reach 109.5 million cases by 2033 as procedures move from hospitals to lower-cost sites of care, including ASCs.

The Sg2 Forecast reveals that the case mix index—a measure reflecting the diversity, complexity and severity of patient illnesses—is up 5% since 2019, the year before the pandemic. At the same time, the average length of stay for patients admitted to a hospital has risen 10%, driven by the increasingly complex nature of the patient population.

These changes are further exacerbating hospital workforce challenges. Staffing shortages in hospitals and high patient acuity—challenges that Sg2 expects will continue into the next decade—along with a shortage of hospital beds will result in more surgeries being performed in ASCs. 


The Forecast projects that pharmaceutical and technological challenges will continue into the next decade. However, during this same timeframe, pharmaceutical and technological advancements will also drive healthcare delivery, including bariatric surgery, to outpatient status and outpatient facilities.  
“Provider organizations also face mounting pressure to redesign care delivery models as pharmaceutical and technological advancements impact procedure types and locations,” according to a news release from Vizient. For example, the Forecast projects nearly 12,000 fewer bariatric surgeries by 2033, representing a 4% decline, because of anti-obesity pharmaceuticals entering the market.

According to the Forecast, outpatient infusion therapy will grow for several service lines. Growth rates include:

  • 48% for rheumatology
  • 37% for gastroenterology
  • 23% for endocrine
  • 18% for dermatology
Like other aspects of non-acute care, healthcare delivered in the home is projected to see growth. Likewise, telehealth will continue to increase in popularity.
Care-at-home innovation is one reason for higher utilization. “Home care volume will increase 20%, driven by a culmination of advances in remote monitoring and digital health capabilities, more favorable payment and lower acuity care shifting to the home setting, enabling reduced patient length of stay and cost avoidance,” according to the Vizient news release.
Meanwhile, virtual visits, which allow physicians to talk to patients in the comfort of their homes, are expected to increase. Sg2 predicts 28% of the 1.67 billion new and established evaluation and management (E&M) visits that will take place by 2033 to occur virtually.

“As the population continues to age and chronic disease incidence rises, we expect increased demand across all sites of care.”
–Tori Richie, intelligence senior director, Sg2.”


The Forecast projects continued rises in patient acuity, which will strain capacity across sites of care. Between 2019 and 2022, 30,000 patient beds closed, creating an additional challenge for delivering care.
“As the population continues to age and chronic disease incidence rises, we expect increased demand across all sites of care,” says Tori Richie, intelligence senior director, Sg2, in the Vizient release. “The reality is access is a challenge for these patient populations and care redesign will be critical to prevent the acute exacerbation of their medical conditions.”
Outpatient volumes will continue to grow as a result of the aging population, which will require more medical visits, imaging and procedures. 

Likewise, chronic care volumes are also expected to increase, and improved care management is needed to meet this demand.
With hospitals facing challenges meeting the growing and changing needs of patients, ASCs can play a key role in improving outcomes. The next decade will provide an opportunity for ASCs to deliver more outpatient treatments than in previous years and grow their business.
Group purchasing organizations such as Provista have the contracts and expertise to help these ASCs intelligently expand their business and optimize the best contracts for their organization. Provista also helps ASC members standardize medical and surgical supplies, reducing capital costs and handling pharmaceutical supply shortages. 

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