The ASC Shift: Standardizing for smarter cost management

Ambulatory surgery centers (ASCs) continue to play a larger role in delivering high-quality, lower-cost surgical care, and are doing so while taking on higher-acuity cases that were once firmly hospital-based. But as inflation, anesthesia expenses, labor shortages and supply chain pressures intensify, many centers find it harder to manage costs without putting outcomes at risk. Traditional cost-reduction tactics — like workforce cuts — often create new challenges, leading to inefficiency, lower morale and unintended effects on quality.

A more sustainable way forward is to reduce unnecessary variation through supply standardization. With more than 6,000 Medicare-certified ASCs in the U.S. — 60% of which are wholly physician-owned — variation in implant technology, supplier mix and purchasing habits continue to drive cost differences that don’t translate into better care. Standardization helps ASCs improve financial performance, strengthen quality and operational integrity, and helps create alignment across clinical and administrative teams.

The most effective organizations approach supply standardization through a structured sequence that emphasizes strong governance, early clinician engagement and evidence-based decisions. In doing so, they shift away from expensive, siloed purchasing to a model that reinforces affordability, consistency and long-term financial sustainability in the ASC.

A roadmap for effective standardization

1. Assess variation: Reducing variation begins with understanding where it exists. Many ASCs carry overlapping products, redundant suppliers and varying technologies that may not improve outcomes — which can add cost to an ASC. Implants, for example, often account for 40–50% of procedural cost, and wide variation in supplier selection and technology use drives unnecessary expense. Identifying these patterns creates a shared fact base and directs attention to categories where standardization delivers the greatest return.

Orthopedics is an especially high-impact starting point. These implants are one of the costliest for an ASC. Standardizing suppliers, where appropriate while maintaining or improving quality, has been achieved in medical devices such as knees, spine and trauma implants, and can significantly reduce cost and meaningfully improve margins. The goal is to match technology to patient needs rather than default to high-end options that offer no additional clinical benefit.

2. Engage clinicians early: Surgeons build preferences over years of experience, training and interaction with vendor representatives. Engaging physicians makes it possible to shift conversations from brand familiarity to objective data such as clinical performance and product attributions.

When physicians are involved in discussions and can see transparent data on utilization, cost and product equivalency, it reframes the dialogue and builds trust. Involving them from the outset turns standardization from a directive into a shared process. When culture, evidence and expectations are aligned, clinicians are more willing to make meaningful changes — including consolidating to a single vendor when the data supports it.

3. Use evidence-based comparisons: Credibility depends on objectivity. Comparing suppliers and technologies through validated clinical research, technical attributes and performance equivalency removes emotion from the equation and focuses the conversation on outcomes. These comparisons reveal where products deliver equivalent performance and where cost differences offer real savings opportunities. When decisions are grounded in data, ASCs gain clarity on which products support both quality and value. Standardized technologies also streamline purchasing, inventory and contracting, creating more predictable operations and measurable improvements.

4. Align incentives: Momentum can stall when clinicians and administrators operate in silos. Clinical teams may not see the financial impact of their choices, and administrative teams may struggle to gain traction without clinical context. Standardization succeeds when there is shared accountability. When departments receive credit for savings achieved through standardization, participation increases and decision-making is smoother. Anonymized data can help physicians evaluate choices without vendor influence, reinforcing objectivity and trust.

5. Secure executive backing: Executive sponsorship positions standardization as an enterprise strategy rather than a departmental project. Strong leadership reinforces adherence helps teams navigate tradeoffs and signals commitment to long-term sustainability. When leaders set clear expectations and hold teams accountable to shared goals, clinical and administrative groups move with more confidence. Aligning recognition and credit structures — for example, ensuring orthopedics receives credit for savings achieved in the surgical department — further strengthens collaboration. Leadership support paired with transparent data builds a culture that values efficiency, quality and responsible resource management.

6. Measure and communicate outcomes: Progress depends on consistent measurement. ASCs should track savings, utilization patterns, operational efficiencies and patient outcomes, then share results openly. Transparency helps build trust, reinforces accountability and highlights where additional opportunities exist. Clear reporting ensures standardization becomes an ongoing discipline rather than a one-time effort. Regular updates also help teams maintain momentum and see how their participation shapes performance.

A sustainable approach to cost management

Organizations that follow these steps consistently have shown to achieve savings in high-cost implant categories — for example, 10%-25% reduction in hips and knees implant costs — without affecting patient satisfaction or outcomes. Standardization also improves operations efficiencies, strengthens supplier partnerships and improves contract compliance.

The path forward for ASCs will demand tighter control of cost drivers and a clearer line between clinical needs and purchasing habits. Standardization offers a way to get there without introducing unnecessary friction into daily operations. With the right structure, the right data and the right support, organizations can shift from reactive cost-cutting to a more sustainable approach that strengthens both performance and outcomes.