Here’s how five of the biggest ASC companies strengthened their market presence over the past year.
United Surgical Partners International (Dallas)
USPI remains the largest ASC operator, holding an 8.1% share of the ASC market. It has interests in 518 ASCs (375 consolidated) and 25 surgical hospitals (seven consolidated) across 37 states. In 2024, USPI added nearly 70 ASCs, maintaining an aggressive approach to mergers, acquisitions and de novo developments. In 2025, the company plans to add 10 to 12 de novo centers.
USPI significantly contributed to the financial success of its parent company, Tenet Healthcare, accounting for nearly half of Tenet’s $3.99 billion EBITDA in 2024. USPI’s own EBITDA grew by 20% to reach $1.8 billion.
Key acquisitions included San Diego-based Synergy Orthopedics and ASC chain Covenant Physician Partners. Tenet aims to sustain growth by investing $250 million annually in ambulatory acquisitions.
SCA Health (Deerfield, Ill.)
SCA Health, a division of Optum, holds a 5% market share with more than 320 ASCs and 9,200 physicians. The company expanded its orthopedic footprint in November by acquiring OrthoAlliance, a private equity-backed firm based in Sharonville, Ohio, which partners with more than 200 physicians across multiple orthopedic specialties.
Optum earned $253 billion in total revenue in 2024 — an 11.7% increase year over year, according to a fourth-quarter 2024 financial report.
AmSurg (Nashville, Tenn.)
AmSurg, holding a 3.9% market share, ended 2024 with over 2,000 affiliated physicians and more than 250 ASCs.
The company pursued multiple strategic partnerships throughout the year. In June 2024, AmSurg partnered with Comprehensive EyeCare Partners to acquire Las Vegas-based Alta Rose Surgery Center. It also entered a joint venture with Palomar Health to manage San Diego-based Poway Surgery Center (San Diego County).
In July, AmSurg acquired a stake in Salem, Ore.-based River Road Surgery Center. In August, AmSurg partnered with Owings Mills, Md.-based LifeBridge Health and Pikesville, Md.-based Woodholme Group to open a gastroenterology ASC in Westminster, Md.
HCA Healthcare (Nashville)
HCA Healthcare, one of the nation’s largest ASC operators, runs its facilities under the Surgery Ventures division. By the end of 2024, it managed 124 ASCs, with an average of 14 outpatient facilities per hospital. Holding a 2.3% market share, HCA Healthcare pursued a growth strategy focused on new facility construction, greenfield developments and targeted acquisitions.
Mr. Hazen said in a third quarter earnings call that HCA Healthcare’s ASC strategy is driven by “greenfield developments,” new facility construction and targeted acquisitions.
In December, HCA Surgery Ventures partnered with healthcare real estate development firm NexCore Group to open an ASC and medical office building in Katy, Texas.
Surgery Partners (Brentwood, Tenn.)
With a 2% market share, Surgery Partners is the third-largest ASC operator, managing over 160 centers and 4,600 physicians. The company received a nonbinding acquisition proposal from Bain Capital Private Equity in January, valuing it at $3.2 billion. Bain Capital, which already holds a 39% stake, has no intention of selling its shares.
In October, Surgery Partners and Leawood, Kan.-based ValueHealth completed a new ASC in The Villages, Fla. In February, Fort-Wayne, Ind.-based Parkview Health entered into an agreement with Surgery Partners to develop ASC ventures across Indiana.
Surgery Partners deployed nearly $400 million on acquisitions and opened eight de novo facilities in 2024. The company’s revenue increased 17.5% in the fourth quarter, reaching $864.4 million, up from $735.4 million in the same period of 2023. Full-year revenue grew 13.5%, reaching $3.1 billion, compared to $2.7 billion in 2023.
For 2025, Surgery Partners projects full-year revenue to be in the range of $3.3 billion to $3.45 billion.
