Choosing a distributor used to feel like a procurement decision. Increasingly, it’s a strategic one.
CMS is moving more procedures into the outpatient setting — adding 560 to the ASC covered list for 2026 alone and phasing out the inpatient-only designation by 2029.¹ Regulatory changes, ownership transitions, and staffing pressures are compressing the margin for operational error. In that environment, the wrong distribution arrangement doesn’t just cost money — it costs time and attention that ASC leaders don’t have to spare.
Before you sign or renew, here are the questions worth asking.
Hospital-focused distributors and ASC-focused distributors are not always the same, even when they’re the same company. The supply dynamics, procedure mix, regulatory environment, and staffing models are different enough that experience in one doesn’t automatically transfer to the other.
“Be intentional about who you choose to work with and especially your distributor,” says Kevin Humphrey, National Vice President of Non-Acute at Cardinal Health. “Really choosing one that truly understands the unique needs of surgery centers.”
The right question isn’t just “Do you serve ASCs?” It’s “How much of your business is ASC-specific, and what have you built for that market?”
Every distributor will tell you they have a reliable supply chain. What differentiates a meaningful answer from a marketing one is the specifics: inventory investment, supplier relationships, and what happens operationally when something goes wrong.
According to Emily Barnhart, Vice President of Strategic Sourcing at Cardinal Health, both Cardinal Health and Medtronic have invested in elevated inventory levels — more days of inventory on hand than strictly required — as a deliberate differentiator for their collaboration.
“We’ve both made investments to bring in higher levels of days of inventory on hand, even more than what’s necessary,” Barnhart notes. “That’s a differentiator for our collaboration in the way that we show up.”
That kind of specificity is what you’re looking for. Anyone can claim supply chain resilience. Fewer can point to the operational infrastructure behind it.
Vendor consolidation is one of the highest leverage moves an ASC can make operationally, but only if the portfolio is deep enough to make it real. A distributor with strong capabilities in two or three categories doesn’t solve a vendor complexity problem.
According to Barnhart, the Performance Plus™ program includes 36 suppliers sole-sourced across 90 product categories. Medtronic holds a position within that program spanning more than 10 categories, representing approximately 40 percent of their product portfolio. For ASC buyers, that breadth means fewer vendors to manage, fewer contracts to negotiate, and fewer calls to make when something goes sideways.
Beyond surgical and monitoring supplies, the Medtronic ASC portfolio spans electrophysiology, pain, spine, urology, and general surgery — covering the full range of procedures moving into the outpatient setting.
There’s a meaningful difference between a distributor who gets you through the purchasing decision and one who stays engaged through clinical adoption. For new facilities, the gap between “equipment delivered” and “team operating confidently” is where most implementation problems live.
“When we come to you on day one, this is not a transaction,” says Tracy McQuay, Senior National Program Manager for ASCs at Medtronic. “This is going to be a collaborative kickoff. Together, we’re going to do that overall assessment of your site and your unique goals and we’re going to co-create a tailored solution to meet those goals for you.”
Capital-light technology options — where new products integrate with your existing fleet rather than requiring full replacement — are worth asking about. They can substantially reduce disruption during transitions.
If your distributor and your key manufacturer don’t have a formal working relationship, you’re the one managing the gap between them. That’s a real cost, even if it doesn’t show up on a line item.
The cadence between Cardinal Health and Medtronic — weekly supply chain meetings, monthly performance scorecards, aligned sales teams — is what enables the “one phone call” experience that ASC operators consistently describe as a differentiator.
“We have the ability to communicate effectively, to prioritize resolution of any challenges,” says Barnhart. “And really what’s important to our mutual customers is the way we show up together.”
That’s the standard worth holding other arrangements to.
The bottom line: Supply chain decisions made quickly tend to be undone slowly. The procedure migration coming into ASCs over the next several years makes now a good time to evaluate whether your current distribution arrangement is built for what’s ahead — or just for what’s already passed.
The full conversation with Tracy McQuay, Emily Barnhart, and Kevin Humphrey is on the ASC Insights podcast. Listen at outcomesrocket.com/ascinsights — and stay tuned for upcoming episodes.
This content was developed in collaboration with Medtronic. The ASC Insights podcast series features real conversations with ASC leaders about the challenges, innovations, and strategies driving success in ambulatory surgery centers.
1. CMS Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Final Rule (CMS-1834-FC), November 2025.