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Sg2 Forecasts Significant Growth in ASC Volume
Gastroenterology, ophthalmology, orthopedics and spine procedures will see the highest increases
BY SAHELY MUKERJI | JUNE 26, 2025
Sg2 released its 2025 Impact of Change Forecast on June 23. The report projects total adult ASC volume to grow 21 percent over the course of the decade, says Tori Richie, senior director of Sg2 Intelligence. “Surgical utilization in the ASC is expected to grow 23 percent and accounts for more than 75 percent of billable activity occurring at this care site” says Tony Guth, senior director of Sg2 Intelligence. “Growth percentages will be higher in markets that adopt ambulatory surgery more aggressively.”
The ASC specialties that will see the most significant growth are gastroenterology, ophthalmology, orthopedics and spine, Richie says. “Demand for surgical services across these service lines continues to grow and we are seeing continued movement of procedures to lower-cost care settings.”
The overall ASC growth trends are similar to last year’s, but some details are taking shape, including the continued movement of traditional health procedures into ambulatory surgery, Guth says. “Ascension acquiring Amsurg is a clear sign from a large national system that ASC investment is critical to accomplishing strategic goals.”
To take advantage of this volume growth, surgery centers need to identify areas of growing need in their markets and determine if it is appropriate for them to invest in these clinical areas, Richie says. “Figure out how you want to play in this space,” she says. “Think beyond the surgical volume—consumers demand more than a simple transaction. Consider how to develop well-integrated care pathways that provide patients the pre- and postoperative support they need to maintain and improve their health.”
Says ASCA Chief Executive Officer Bill Prentice, “If these projections hold, both CMS and commercial payers must ensure that surgery centers remain a viable alternative to provide this care. Fair reimbursement and reduced regulatory burdens are essential.”
Other Highlights
The report also highlights an 18 percent growth in adult outpatient (OP) volumes and a 5 percent increase in adult inpatient (IP) discharges over the next decade, according to a release. The annual 10-year forecast provides insight into anticipated shifts in care delivery across the nation, including emerging trends in pediatric care, cancer outpatient volumes, the impact of GLP-1s on disease management and projections for post-acute care.
As care continues to shift to outpatient settings—reaching 6.03 billion in volume by 2035—annual inpatient discharges are still projected to reach 31.9 million by the end of the decade, with individuals aged 65+ accounting for more than half of these discharges, according to the release. These patients will bring with them multiple comorbidities, such as congestive heart failure and behavioral health conditions, requiring longer and more intensive hospital stays. Inpatient days are expected to rise by 10 percent, to 175.8 million days—a trend that will exacerbate existing capacity issues.
At the same time, pediatric OP growth is forecasted to grow 8 percent over the next 10 years to 881.8 million in volume, the release states. Pediatric IP discharges will peak at 1.6 million next year, excluding births, before slowly declining throughout the decade due to changes in birth rates.
“These forecasts reflect a changing care landscape that will require health systems to adjust both their physical footprints and clinical operations,” Richie said in the release. “Depending on the market, health systems may consider growing their post-acute footprint, investing in offerings, such as remote patient monitoring or virtual nursing to scale home-based care.”
The Impact of Change Forecast also highlighted several service line trends across the nation, according to the release, including
Cancer outpatient volumes—Cancer OP volumes are expected to grow 18 percent to 222.0 million in volume over the decade while IP volumes remain flat. Rising cancer prevalence in young adults indicates the need for the development of new programs to better target, diagnose and treat this younger patient population.
GLP-1 update—Driven largely by consistent GLP-1 use, type 2 diabetes inpatient discharge growth will slow to 8 percent, or 693,000 discharges, versus a population-based forecast of 12 percent growth. This potential reduction has wide-ranging implications for capacity planning, chronic disease management programs and financial projections across health systems.
“By 2035, evaluation and management visits for diabetes are expected to grow 26 percent, reflecting the intensive care management needed for diabetic patients on GLP-1s,” said Emily Fitt, senior consultant of Sg2 Intelligence, in the release.
Post-acute care—Post-acute care is expected to grow by 31 percent to 704 million in patient volume over the next decade, representing a significant opportunity to extend services to older and medically complex populations in a lower-cost setting. Health systems are encouraged to integrate home-based services into broader strategies for capacity management and care orchestration.
“The future of post-acute care is being written at home,” said Nikita Arora, senior consultant of Sg2 Intelligence, in the release. “Recovery is shifting from hospitals and skilled nursing facilities into living rooms and local communities—driven by the convergence of an aging population, consumer preferences/demand, system strain and payer push for value. For lower-acuity procedures that are safe to recover from at home, health systems are scaling smarter, leaner care models: virtual rehab, remote monitoring, transitional care and nurse-led recovery solutions that extend clinical precision beyond the hospital walls. It’s not just a site-of-care shift—it’s a redesign of recovery itself.”
Read more about Sg2’s 2025 Impact of Change Forecast.