Certificate of need legislation makes a big difference for surgery center development.

Nashville, Tenn.-based HCA Healthcare is one of the largest ASC companies in the country. 

Dallas-based United Surgical Partners International and SCA Health are two of the largest ASC chains, with more than 475 and 320 ASCs, respectively. 

SCA Health, an affiliate of Optum, has had a slow year of ASC activity since the company rebranded last May and expanded its focus beyond surgery centers.

MedVanta, the largest physician-owned musculoskeletal management services organization in the nation, is partnering with Physicians Surgery Center of Frederick, according to a July 6 news release.

The ASC industry is slowly consolidating, and five major moves in the last year point to how the industry is shifting. 

A 10,000-square-foot medical office building in East Windsor, N.J., has sold for $2.95 million, according to a July 6 report from roi-nj.com. 

Five ASCs have said they would close their doors this year, citing low patient volumes, financial strain and more.

United Surgical Partners International has more than 475 surgery centers, the most of any ASC chain. 

Surgery center chains have consolidated in the last decade to five mega-companies and a handful of small regional chains with growth prospects simmering.

The ASC market has shifted in the last decade with consolidation between ASC chains and more surgery center development overall, but the percentage of independent surgery centers overall hasn't drastically shifted.

UnitedHealth Group's Optum, parent company of ASC chain SCA Health, is on a spending spree, acquiring more than $10 billion worth of companies in the last year. 

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Private equity has been the largest acquirer of private physician practices over the last five years, according to 2023 data from the American Hospital Association.

The Englewood, Colo.-based Dry Creek Medical Campus, which is anchored by a full-service ASC leased to Englewood-based Orthopedic Centers of Colorado in partnership with Deerfield, Ill.-based SCA Health, has sold to Remedy Medical Properties and Kayne Anderson Real Estate, according to a June 26 report from REBusiness Online. 

An 82,328-square-foot Methodist Southlake (Texas) medical office building outside of Fort Worth, Texas, attached to a Methodist hospital has sold, according to a June 26 report from Rebusiness Online.

UnitedHealth Group's Optum has agreed to merge with Amedisys, a home health and hospice provider.

A 22,700-square-foot North Haven, Conn.-based medical office building has sold for $1.5 million, according to a June 23 report from the Hartford Business Journal.

Here are five ASC chains that have grown their footprint so far in 2023: