Orthopedics' Shift to ASCs Redefines Care Delivery

The move away from hospitals to ambulatory and office-based settings represents a major change in musculoskeletal care.

Apr. 6, 2026 at 4:55pm

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A ghostly, translucent X-ray photograph revealing the intricate internal structures of a human knee joint, symbolizing the technological advancements enabling the shift in orthopedic care delivery.Advancements in orthopedic care are enabling a shift from hospital-based to outpatient procedures, transforming how patients experience musculoskeletal treatment.Chicago Today

The center of orthopedic care is shifting from hospitals to ambulatory surgery centers (ASCs) and office-based settings, driven by improvements in surgical techniques, perioperative care, and a broader trend toward delivering care in lower-cost, more focused environments. This transition is shaping long-term strategy for organizations like OrthoCarolina, prompting a reevaluation of traditional partnership models and a focus on providing value to patients through improved access, convenience, and affordability alongside clinical outcomes.

Why it matters

The shift in orthopedic care delivery represents a fundamental change in patient expectations, with many procedures now being performed as same-day cases in ASCs rather than requiring multi-day hospital stays. This transition is challenging long-standing assumptions about the relationship between cost and quality, as organizations seek to lower costs while maintaining or improving outcomes.

The details

For Leo Spector, MD, orthopedic spine surgeon and CEO of OrthoCarolina, the move away from hospitals is one of the most significant changes in musculoskeletal care in decades. Recent changes to North Carolina's certificate-of-need laws have opened new opportunities for physician groups to develop and operate ASCs more independently, prompting OrthoCarolina to reevaluate traditional partnership models. The organization now owns and manages two ASCs, with a focus on understanding what matters most to patients, including access, convenience, and affordability alongside clinical outcomes.

  • North Carolina's certificate-of-need laws were recently changed, opening new opportunities for physician groups.
  • OrthoCarolina has developed and now owns and manages two ASCs.

The players

Leo Spector, MD

Orthopedic spine surgeon and CEO of OrthoCarolina.

OrthoCarolina

A physician group that has developed and now owns and manages two ambulatory surgery centers in North Carolina.

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What they’re saying

“I think the biggest shift that's occurring in musculoskeletal care is the shift from inpatient, hospital-based surgery to outpatient, ambulatory or office-based surgery.”

— Leo Spector, MD, Orthopedic spine surgeon and CEO of OrthoCarolina

“When you're having elective musculoskeletal procedures, it's great to be in an environment that's different.”

— Leo Spector, MD, Orthopedic spine surgeon and CEO of OrthoCarolina

“Less expensive doesn't mean less better. Less expensive can actually be a better product.”

— Leo Spector, MD, Orthopedic spine surgeon and CEO of OrthoCarolina

What’s next

The Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, will bring together spine surgeons, orthopedic leaders, and ASC executives to explore the future of outpatient spine care.

The takeaway

The shift in orthopedic care delivery represents a fundamental change in patient expectations and the relationship between cost and quality. Organizations like OrthoCarolina are adapting by expanding access to care, adopting new technologies, and focusing on providing value to patients through improved convenience, affordability, and outcomes.