Many physicians walk into ASC planning already leaning one way: "I want an ambulatory surgery center just for my specialty.” It's a natural instinct, but instincts don’t always drive the best outcomes.

The highest-performing ASCs balance two forces: operational efficiency and financial return. Nail the operations, and the financials usually fall in line.

If you're weighing your ASC partnership options, here's a breakdown of how single-specialty and multispecialty models compare operationally, complete with a quick-hit chart to help you make the call.

The Case for Single-Specialty Simplicity

There’s a lot to like about a single-specialty ASC. You can design it around one type of care, invest in highly specialized equipment, and recruit laser-focused staff who know your work inside and out.

In a single-specialty ASC, you are more likely to get that sweet ‘silent symphony’ in the OR. Everyone knows what you need before you even ask.

A single-specialty focus also supports lean facility design. For example, a high-volume orthopedic ASC may need only two ORs in 7,500 square feet of total space. That kind of efficiency can be incredibly appealing, particularly as building costs for de novo ASC costs rise.  

When Multispecialty Makes Sense

But what if your single-specialty ASC can’t fill two ORs consistently? As a physician partner, you’re heavily invested in those ORs, so how do you maximize them for the highest case volume and highest yield possible? That’s where multispecialty ASCs offer a savvy alternative.  

The key to a lean multispecialty ASC: Pair specialties that play well together, sharing similar equipment, supplies, and surgical teams. For example, you might combine orthopedics with spine surgery or pain management. Or gastroenterology with general surgery.

Pairing complementary specialties with similar acuity can help streamline your setup, avoid costly duplication, and maintain operational efficiency.

Plans for a multispecialty ASC can quickly become inefficient — and expensive — if you start adding specialties without a strategy. If an orthopedic ASC adds one ENT physician, for example, partners may need to invest in a $300,000 microscope. Does that make sense for just one ENT surgeon? Know your break-even volume before committing and resist the urge to become all things to all patients and providers.

Let the Data Drive Your Decision

One of the most common mistakes I see is physicians making decisions before evaluating all the data. They come in convinced a single-specialty model is the only way to go. And that might be true, but it’s not always.

Case volume potential is everything. Even the best-designed single-specialty ASC falls short if it’s not being used enough. Your ORs are valuable only if they’re active. Before committing to any model, study the data and ask, “Can this model support three or more days of surgery per week?”

At Compass, we help our physician partners discern the best option for the partnership: a highly efficient, two-room, single-specialty ASC, or a larger, multispecialty center built around like-minded physicians and complementary procedures. Both can succeed. What matters is that the strategy fits your service area, your team, and your long-term goals.

So stay flexible. Let the numbers guide you. We’ve built both types of centers, and we know how to make them work. We’re here to help you find the model that works best for your practice.  

Size your ASC based on projected specialty mix and case volume with our OR Case Volume Download — access it here.

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Comparison: What You Gain (or Give Up) With Each ASC Model

Whether you're building a single-specialty powerhouse or planning for long-term diversification, the best ASC model is the one that aligns your volume, vision, and goals. Let’s talk about how we can help you get there.

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