States vary greatly in terms of ASC accessibility

The number of ASCs in the United States has grown steadily over the past decade, reaching approximately 8,000 active facilities as of 2019. However, the geographical distribution of these surgery centers is far from even. Looking at the average number of residents that an ASC can serve in each state demonstrates just how widely different areas of the country differ.

Residents per ASC by state
State Residents per ASC Rank in U.S.
Maryland 16,358 1
Georgia 22,883 2
Arizona 24,721 3
U.S. (average) 41,746 Average
Alabama 101,347 48
West Virginia 140,696 49
Vermont 312,489 50
  • Maryland leads the nation in ASC concentration; the average ASC can serve 16K potential patients
  • Vermont, a mostly rural state, has the lowest ASC concentration in the US, with 300K residents per facility—given the state population, ASCs in Vermont have to serve nearly 20 times more potential patients than ASCs in Maryland

Driving distance to ASCs

Nationally, the average driving distance for a US resident to the nearest ASC is about 11 miles. This average includes ~66% of Americans who live in the same zip code as an ASC and thus have easier access to ASC-based care.

However, this access is not consistent across the country, with nearly 34 million Americans live more than 30 miles away from the nearest ASC.

ASC Map

Lack of accessibility in Rural States

Many rural regions across the country have no ASCs in their proximity, meaning residents there are forced to drive long distances to access healthcare in these facilities. Given that procedures performed in ASCs are same-day surgeries, living too far away makes driving to and from the facility in a single day burdensome if not impossible. Residents in primarily rural states (e.g., Alaska, Montana, and South Dakota) have to drive, on average, more than 25 miles to reach the nearest ASC

Residents in primarily rural states (e.g., Alaska, Montana, and South Dakota) have to drive, on average, more than 25 miles to reach the nearest ASC

States with the longest drives to the nearest ASC (average miles per resident):

  1. Alaska (55 miles)
  2. Montana (28 miles)
  3. South Dakota (25 miles)
  4. Vermont (24 miles)
  5. Wyoming (22 miles)
Medicare patients face difficulties accessing Orthopaedic ASC-based care

As we'll discuss in later posts, Orthopaedic surgeries are increasingly migrating from hospitals to ASCs, given Medicare's recent decision to cover procedures like hip replacements and total knee replacements in ASC settings.

However, regardless of reimbursement policy and industry dynamics, the reality is that many Medicare patients lack adequate access to Orthopaedic ASCs.

Roughly 1/4 of Medicare-eligible Americans live more than an hour drive away from the nearest ASC that performs knee replacements

This was the first blog post in AcuityMD's ASC-blog post series in which we'll be looking at the shifting dynamics of the ASC market through the lenses of access to high quality care, reimbursement trends, COVID-19, and much more. Stay tuned for our next post!