Regulators at the Green Mountain Care Board have greenlit a plan for a freestanding multi-specialty surgery center in Hartford, clearing the way for the Upper Valley Surgery Center to open up shop as soon as next year.

Ambulatory surgery centers offer same-day surgeries and other care that doesn’t require hospitalization. Such surgery centers are increasingly popular across the country, but exceedingly rare in Vermont, where strict regulations and hospital opposition have stymied projects in the past.

The Upper Valley Surgery Center’s owners say their facility will reduce wait times in the region and offer patients a cheaper alternative to hospital care that’s just as safe. In a unanimous decision, regulators said they agreed.

Strafford urologist Michael Curtis will be one of the Upper Valley Surgery Center’s founding doctors. Although he maintains an independent practice, he said reimbursement rates are so poor he doesn’t take a salary — it’s a part-time gig at Mt. Ascutney Hospital that pays his bills. He wanted to find a way to access better reimbursements without sacrificing autonomy.

“I really love being a physician. I love being a surgeon. I love fixing things, and what I’m not loving is the loss of control,” he said.

Curtis and his partners are preparing to close on a former car dealership in White River Junction on Ballardvale Drive, right off Interstates 89 and 91. The building must undergo major renovations before the surgery center can open.

According to regulatory filings, the planned 15,000-square-foot center will have four operating rooms and offer orthopedic, spine, gynecological and urologic procedures to start.

It takes months, on average, for patients in the Upper Valley to get the sort of procedures — like knee replacements and laparoscopic hysterectomies — the surgery center plans to offer. The Upper Valley Surgery Center told regulators it should be able to deliver that care within about 30 days. It will accept both publicly and privately insured patients, as well as those paying out of pocket.

Misty Blanchette Porter, a gynecologist and fertility specialist who currently works at the University of Vermont Larner College of Medicine, will also practice at the new center. She said she wanted to return to delivering care to women and families in a more local setting without compromising quality.

“Vermont is at a precipice where other models of care are really necessary,” she said.

Medical advances have made it easier and safer to deliver more surgical procedures on an outpatient basis, and consumers and insurers alike want lower-cost options. Research generally indicates that outcomes at surgery centers are as good as they are in hospitals.

That’s led to boom times, nationally, for ambulatory surgery centers. But there’s little evidence of that trend in Vermont. There are only two freestanding surgery centers here, and only one, the Green Mountain Surgery Center in Colchester, is a multi-specialty facility.

Vermont has fewer surgery centers per capita than any other state in the country, according to the federal government. For comparison, an industry group counts 29 surgery centers in New Hampshire and 15 in Maine.

“It’s, I think, not a fluke that Vermont has both the most expensive healthcare insurance and the fewest number of ASCs,” Curtis said.

Indeed, as Vermont’s healthcare costs have soared in a hyper-consolidated healthcare market, the state’s political and regulatory environments have grown more inclined to encourage competition. Lawmakers, for example, recently exempted freestanding birth centers from needing to get approval from the Green Mountain Care Board, and the state’s first birth center is now in the works for central Vermont.

It took years for the Green Mountain Surgery Center, which faced opposition from nearby hospitals, to get the final go-ahead from the board. But regulators signed off on the Upper Valley project within six months and imposed far fewer conditions than they have in the past.

Owen Foster, the chair of the board, supported legislative efforts to reduce the number of healthcare facilities that require GMCB approval. And he said it wasn’t an accident that the Upper Valley project received a more expedited review.

“We want to increase the opportunity for competition and lower-cost providers to enter the state,” he said. “I think some of what you’re seeing in that decision reflects this evolving view.”