Running an ambulatory surgery center (ASC) is not for the faint of heart. ASC leaders are navigating tight margins, stricter-than-ever quality reporting, lean staffing resources, payer squeeze, and a relentless push to be profitable without proper support. And yet, the ASC market is booming. The number of Medicare-certified ASCs has grown to more than 6,500 nationwide, and with more complex cases shifting outpatient—total joints, spine, and robot-assisted procedures—the pressure to evolve and grow is only getting more intense.