Ambulatory surgery centers (ASCs) continue to play a growing role in delivering high‑quality, lower‑cost surgical care. To better understand the financial landscape of these facilities, Elizabeth Plummer, PhD, Professor at the Neeley School of Business at Texas Christian University, and her co-authors conducted an in‑depth study using financial data from the Pennsylvania Health Care Cost Containment Council (PHC4) alongside operational information from the Pennsylvania Department of Health’s Division of Health Informatics.
Dr. Plummer noted that ASCs are often central to policy conversations on reducing health care costs while maintaining quality. However, national data gaps, particularly the absence of Medicare cost reporting by ASCs, limit visibility into their true financial performance. “PHC4’s data allowed insight into understanding costs, margins, and payment adequacy to help inform policy discussions regarding payment and patient access to care,” she shared.
As more surgical services shift from hospitals to outpatient settings, Dr. Plummer and her colleagues examined the financial and operational characteristics of Pennsylvania’s ASCs, comparing nonprofit and for‑profit facilities across patient volume, specialty, system affiliation, net patient revenue, profit margins, and other key indicators. Their findings are published in Profitability of Nonprofit and For-profit Ambulatory Surgery Centersi. The study documented strong profitability for both nonprofit and for-profit ASCs, with nonprofit facilities standing out in several dimensions. Dr. Plummer explained, “Although nonprofit ASCs represented only one‑fifth of all facilities and one‑third of patient volume, they accounted for more than half of total net income in Pennsylvania’s ASC market in 2024. The nonprofit ASCs exhibited significantly higher profit margins than for-profit ASCs, while continuing to maintain their tax‑exempt status.”
The findings provide information that may be relevant to ongoing discussions surrounding site‑neutral payments and outpatient surgical care. With 94.3% of nonprofit ASCs in Pennsylvania operating under health systems, these findings contribute information that may be used by researchers and policymakers examining outpatient facility characteristics and payment systems. Dr. Plummer noted that the study highlights how high‑quality, transparent financial data can support research and analysis related to outpatient surgical care.
Dr. Plummer also emphasized the value of PHC4’s data resources in making this research possible. She described PHC4’s data as both timely and affordable, noting that Pennsylvania is the only state she is aware of that requires ASCs to report financial information. She praised PHC4 staff for their responsiveness, professionalism, and deep understanding of the datasets.
Dr. Plummer’s work highlights the essential role PHC4 plays in advancing health services research and informing evidence‑based policy decisions. As ASCs continue to evolve within the healthcare landscape, PHC4’s comprehensive and accessible data will remain a critical asset for researchers and policymakers alike.
i Plummer E, Doyle K, Bai G. Profitability of Nonprofit and For-Profit Ambulatory Surgery Centers. JAMA Health Forum. 2026;7;(9):e263332
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