In the third installment of our case costing series, HST Pathways’ Chief Innovation Officer, Gavin Fabian, breaks down what “mature” case costing actually looks like in a real ASC (and why, done right, it’s pretty boring). The conversation covers why so many initiatives fall apart at the cost-data level, how to clean up your item master and documentation workflows, and practical steps to move from retrospective spreadsheets to automated case profitability forecasting. Gavin also shares where AI can help plug data gaps, where forecasting should live in your scheduling workflow, and how to use these insights to drive surgeon alignment without sacrificing culture.

In the data segment, we discuss a custom metric from HST’s demographic benchmarking report: OR Minute–Case Gap (by Sex). You’ll hear how this metric is calculated from a 5.3 million–case dataset, what national patterns look like in specialties such as Cardiovascular and Spine, and how ASC leaders can use these insights to challenge assumptions about block times, staffing, and scheduling — so days run closer to plan..

Resources mentioned:

Who’s on Your Schedule? Demographic Trends and Benchmarks for ASCs

Who’s on Your Schedule? Exploring Demographic Data for ASCs (Podcast)

HST Pathways 2025 Client Award Nominations

Brought to you by HST Pathways.

In this week’s episode, the second installment in our case costing series, Grant Duncan sits down with VMG Health’s Vanessa Sindell and Nancy Stephens to unpack the unsung hero of accurate case costing: a clean inventory master. They cover practical, do-it-today tactics like using naming conventions that work at the point of care, leveraging GPO data to understand all of your pricing options, and keeping preference cards current, so cost-per-case is surgeon ready. They also make the case for dedicating an FTE to the process to maximize cost savings.

In the news: the still-pending OPPS/ASC final rule, the implications of CMS site-neutrality efforts, a new analysis drawing scrutiny to UnitedHealthcare’s payments to Optum-employed physicians compared with market peers, and encouraging results for a multi-cancer blood test showing high detection accuracy alongside standard screening.

Resources Mentioned:

VMG Health

CMS’ delayed ASC rule release, explained (Becker’s ASC Review)

CMS’ site-neutral reform poised to upend hospital-ASC dynamics (Becker’s ASC Review)

Study suggests UnitedHealthcare pays Optum docs more than other providers (Fierce Healthcare)

A simple blood test can detect 50 types of cancer: We explain (USA Today)

Brought to you by HST Pathways.

This week’s guest, Melissa Rice, is the administrator at Loyola Ambulatory Surgery Center at Oakbrook Terrace (part of Trinity Health), and the newly elected Illinois Ambulatory Surgery Center Association President. In the first episode of our Case Costing series, Melissa lays out a practical playbook that changes behavior — how to pull the levers that drive profitability (implants, supplies, staffing), why clean data must come first, how subspecialty data can surface margin-wrecking outliers, and the right way to align your staff, surgeons, vendors, and your board using clear numbers and transparent governance.

In our data segment, we spotlight the Days to Bill benchmark — which rose to 4.4 days on average in 2024 from 3.6 in 2023 — and a few specialty-specific improvements. We talk about why this metric matters, what it can indicate, and a few simple ways to accelerate cash while mitigating denial risk.

Resources mentioned:

HST Pathways State of the Industry Report

HST Pathways Spine Specialty Data Report

HST Pathways Cardiovascular Specialty Data Report

HST Pathways Gastroenterology Specialty Data Report

Brought to you by HST Pathways.

Recorded live at the New York State Association of Ambulatory Surgery Centers conference in Albany, NY (Oct 6-8), this special edition episode brings three vantage points on where ambulatory surgery is headed next: Dr. Daniel Choi of Spine Medicine & Surgery of Long Island on scaling a multi-physician practice with 10,000+ annual visits and what it really takes to plan an ASC; JoAnn Vecchio of ASC of Western New York on sustaining growth and continuity through a partnership with Catholic Health; and Kara Newbury of ASCA on how a federal shutdown could affect timelines and current legislation — and what ASC leaders should prioritize now amid uncertainty.

One theme connects them all: ASCs are built for this moment — safer care, smarter costs, and real runway for growth — if you can execute.

Resources mentioned:

Ambulatory Surgery Center Association (ASCA)

Brought to you by HST Pathways.

This week, Will Evans, Head of Data Science & Insights at HST Pathways, joins us to unpack our new five-and-a-half-year look at how case volume, OR minutes, and dollars are distributed across patient demographics. We discuss the biggest findings, a few surprises, and the simple metrics any ASC can track to anticipate scheduling and staffing nuance by population.

In our news segment, we cover venture fundraising in the ASC industry, a recent survey report showing a growing number of health systems making ASCs a core part of their strategy, how cyberattacks have disrupted patient care at hundreds of healthcare organizations this year, and a new FDA-cleared blood test to aid in initial Alzheimer’s assessments.

Resources mentioned:

Report: Who’s on Your Schedule? Demographic Trends & Benchmarks for ASCs

Oath Surgical Raises $24M to Expand Surgeon-Led Centers, Develop AI Platform

Health systems expand ambulatory strategies: Report

In 2025, patients are in the healthcare cybersecurity crosshairs

Roche, Lilly's blood test for Alzheimer's diagnosis gets US approval

Brought to you by HST Pathways.

In this episode, Benita Tapia, Administrator & Director of Nursing at Beverly Hills ASC, joins Alex — along with Conor McGinn, CEO of Akara — to unpack how she’s using AI to improve everyday operations: tightening block utilization and surgeon accountability, speeding turnovers, answering scheduling questions in real time, and boosting registration accuracy to cut preventable denials. We also cover the guardrails — privacy, policy, and a human in the loop — that keep these tools safe and useful.

In our data segment, we look at Otolaryngology benchmarks from nearly 112,000 cases across 202 centers. OR block utilization sits around 46%; net revenue per case is up 26% ($2,981 to $3,765); deposits slipped, and denials ticked up while days to bill improved. We highlight trends to watch, and simple steps leaders can take now to tighten collections, curb denials, and move closer to that 70% utilization goal.

Resources mentioned:

HST Pathways State of the Industry Report

HST Pathways Otolaryngology Benchmark Report

Brought to you by HST Pathways.

As Q3 wraps, this episode spotlights the signals that matter for ASC leaders heading into the busiest quarter of the year. We track policy direction, the continued shift of cases to outpatient settings, and how employer data transparency is accelerating site-of-care redirection. We scan market momentum and partnerships, revisit anesthesia coverage and how centers are adapting, and share pragmatic AI wins that tighten schedules and improve RCM. Skim the quarter’s major ASC trends in under 20 minutes to guide Q4 execution and set up 2026 planning.

Resources mentioned:

CMS proposed CY-2026 OPPS/ASC rule

ICD-10-CM FY-2026 code update

National Alliance of Healthcare Purchaser Coalitions Pulse of the Purchaser 2025 Survey

Tenet Reports Strong Second Quarter 2025 Results; Raises 2025 Financial Outlook

Ascension nears $3.9B AmSurg acquisition: Bloomberg

Avanza Strategies 6th Hospital Leadership ASC Survey

JAMA Surgery, Effect of a Predictive Model on Planned Surgical Duration Accuracy, Patient Wait Time, and Use of Presurgical Resources

Becker’s ASC Annual Meeting, October 16–18, Chicago

Brought to you by HST Pathways.

For the final episode of our Improving the Patient Experience series, show co-host Grant Duncan and Marta Shultz, a clinical workflow expert at HST Pathways, join Alex to unpack pre-assessments — why they’re essential for patient safety and satisfaction, when to complete them, how many forms you actually need, and practical ways ASC leaders can reduce nurse phone time and cut cancellations and delays.

In our data segment, we analyze gynecology benchmarks from 33,000+ cases across 99 centers. OR block utilization fell 10% year over year to 41%, while a number of financial metrics improved. We cover trends to watch, and steps leaders can take to curb operational challenges at their own centers.

Resources mentioned:

HST Pathways State of the Industry Report

HST Pathways Gynecology Benchmark Report

Brought to you by HST Pathways.

Jeffrey Flynn, Administrator and Chief Operating Officer at Gramercy Surgery Center and President of the New York State Association of Ambulatory Surgery Centers, joins the show to share how Gramercy keeps care personal at scale — training every team member as a patient advocate, keeping families informed, and even empowering nurses to call a case when something feels off. He also gives us insight into what the NYSAASC has been up to and previews what’s ahead for New York ASCs as we approach next month's state conference in Albany.

In our news recap, we’ll cover why anesthesia providers are choosing ASCs, CMS’s proposed 2.6% payment update and additions to the ASC-Covered Procedures List fueling industry growth, ASCA’s July 60-Second Survey on EHR adoption, and a nationwide study in New Zealand using AI to speed stroke imaging.

In or near New York? Join us at the NYSAASC Conference in Albany, NY, at the Desmond Hotel, October 6-8, 2025.

Resources mentioned:

Why anesthesia providers are drawn to ASCs

The policy shifts driving the ASC boom

ASCA Survey Shows Continued Growth of EHR Usage by ASCs

National rapid stroke imaging AI study underway in New Zealand

Brought to you by HST Pathways.

In this episode, Grant Duncan sits down with Katie Sypher, a registered dietitian and healthcare operations leader, and Michael McClain, founder of LeftCoast Healthcare Advisors, to tackle one of the most overlooked challenges in the ASC space: communication. They share practical strategies for aligning messaging between clinics, surgery centers, and patients — covering everything from mapping touchpoints to creating a single source of truth to reduce duplication, avoid confusion, and build patient trust.

After that, tune into our Data & Insights segment, where we explore why ASCs saw claim denial rates drop from 8% to 4% in 2024 — a 50% improvement — and what your center can do to replicate that success.

Resources Mentioned: 2024 State of the Industry Report by HST Pathways

Brought to you by HST Pathways.