Part 2: Looking Back at Becker’s ASC Roundtable — Navigating Payers and Smarter Growth

Author:
Jessica Thurston, Vice President, Client Development at nimble

In Part 1, we looked at what ASCs can control internally — clearer messaging, organized contracts, and operational discipline that builds leverage. 

But the second half of the Becker’s ASC Roundtable centered on what ASCs cannot simply fix alone: payer responsiveness, reimbursement realities, and the strategic decisions shaping growth in 2026. 

Despite these external pressures, ASC leaders in the room weren’t discouraged. In fact, they were remarkably aligned on two things: 

1. Payer friction is real and persistent.
2. ASCs are adapting faster than the payer landscape itself.  

Here are the key themes that emerged:

1. Payer Responsiveness Remains the Biggest Bottleneck — But Persistence Wins 

No topic generated more nodding heads than payer responsiveness. Every leader had a version of the same story — unanswered emails, days lost in portals, authorizations that stall without reason. 

But the ASCs actually breaking through aren’t doing anything glamorous. They’re doing the unrewarded but essential work: 

• Documenting every outreach
• Escalating professionally and consistently
• Building real human relationships inside payer organizations
• Bringing employer data or community impact into negotiation conversations    

The room was clear: payers may not move quickly, but disciplined follow-through creates traction. 

The mindset has shifted from frustration to intention. 
ASCs aren’t waiting for payers to become easier to work with — they’re building repeatable systems that cut through inertia. 

2. ASC Growth Isn’t Slowing — It’s Becoming More Strategic 

A few years ago, ASC expansion often mirrored momentum — more specialties, more equipment, more cases. 

Today, the leaders in the room are more measured and more analytical. 

They’re asking smarter questions before they grow: 

• Does the case mix model actually support reimbursement? 
• Are self-funded employers in the market aligned with these services? 
• What does the local hospital and payer landscape look like?
• Where is the real economic value — not just clinical capability?  

This shift doesn’t mean growth is cooling. It means growth is maturing. 

One leader put it plainly: “We’re not adding specialties because we can — we’re adding them where value and economics support it.” 

This discipline is building stronger, more resilient centers — not just bigger ones. 

3. The Future Favors the ASCs Who Adapt the Fastest 

What emerged from the discussion wasn’t frustration — it was clarity. 

ASCs are refining their payer strategies. 
They’re strengthening their contract infrastructure. 
They’re improving how they tell their value story. 
And they’re building growth plans grounded in data, not assumptions. 

The environment may not suddenly simplify, but ASCs are sharpening their operations faster than the payer landscape is shifting. 

That speed — that willingness to adjust, document, simplify, and respond — is becoming the real competitive advantage. 

Closing Thoughts 

The realities of payer engagement aren’t going away anytime soon. But the ASC leaders around that table were far from discouraged. 

They were focused. Clear-eyed. Strategic. 

They’re tightening internal processes, elevating their messaging, and building smarter growth strategies — not because the market is easy, but because they’re determined to stay ahead of it. 

If you’re preparing payer conversations, new service lines, or contract strategy for 2026, let’s connect. A focused 20-minute discussion now can save months of chasing later.