Xiaoxi Zhao, PhD | RamaOnHealthcare – Healthcare Expert Profile

Aligning incentives to Boost Ambulatory Surgery Center Utilization

A new study highlights how aligning patient and insurer incentives – through greater price openness, lower out-of-pocket costs, and expanded network access – could significantly increase the use of ambulatory surgery centers (ASCs) and improve patient access to care.

Published by AJMC on November 8, 2025, the research, titled “Pricing and Insurance Networks in Outpatient Surgery Markets,” underscores the potential of ASCs to offer a more affordable and accessible alternative to traditional hospital outpatient departments. Lead investigator Xiaoxi Zhao, phd, argues that strategic adjustments to the current healthcare payment landscape are crucial to unlocking this potential.

The Case for Ambulatory Surgery Centers

ASCs have emerged as a key component of the evolving healthcare landscape, offering a cost-effective setting for a wide range of surgical procedures. However, despite their advantages, utilization rates remain below their potential. According to Dr. Zhao, a primary barrier to wider adoption lies in misaligned incentives between patients and insurers.

“Currently,the system frequently enough doesn’t adequately reward patients for choosing lower-cost,high-value ASCs,” explained Dr. Zhao. “This can lead to patients unknowingly incurring higher expenses, even when a perfectly suitable ASC option is available.”

Did you know? – ASCs generally have lower overhead costs than hospitals, allowing them to offer procedures at a reduced price. This can translate to notable savings for patients and insurers.

Key Findings and Recommendations

The study’s findings point to three key areas for enhancement:

• Price transparency: Patients need clear, upfront details about the costs associated with different surgical settings. This empowers them to make informed decisions based on both clinical quality and affordability.
• Reduced Out-of-Pocket Costs: Lowering patient cost-sharing for ASC procedures can incentivize utilization. This could involve lower deductibles, copays, or coinsurance.
• Broader Network Inclusion: Insurers should expand their networks to include more high-quality ASCs, providing patients with greater choice and access.

These changes, Dr. Zhao contends, would not only benefit patients financially but also contribute to a more efficient and sustainable healthcare system.

Pro tip: – Before scheduling surgery, patients should proactively inquire about ASC options and compare costs with hospital outpatient departments.Don’t hesitate to ask your doctor for recommendations.

Future Research Directions

While the study provides valuable insights, Dr. Zhao emphasizes the need for continued research. Specifically, she calls for investigations into how market consolidation, changes in ASC ownership models, and the entry of new players impact prices, access, and ultimately, patient outcomes.

“Further research will help us identify and address any potential challenges that may arise as the ASC sector continues to grow,” stated Zhao.

For a more in-depth understanding of the study’s methodology and findings, viewers can watch parts 1 and 2 of a related video series.

This transcript has been lightly edited for clarity; captions were auto-generated.

Reader question: – How might increased ASC utilization affect the quality of surgical care? What safeguards are needed to ensure patient safety?