Dallas-based United Surgical Partners International, Tenet Healthcare's ASC arm, is the largest ASC chain in the country, with interest in 461 ASCs and 24 surgical hospitals throughout 35 states.
The company saw a strong year across service lines, citing growth in gastroenterology, urology, ENT, orthopedics and ophthalmology, as well as "physician additions across the board," CEO and Chair Saum Sutaria, MD, said Feb. 8 during the company's fourth-quarter earnings call, according to Seeking Alpha.
Additionally, USPI saw 9.2% growth in same-facility revenues, 1% to 3% case growth, and total joints were up nearly 20% in the fourth quarter.
"This organic growth was driven by continued expansion of service lines and growth in our population of partnered and affiliated physicians, as well as the fundamental tailwinds of patient demand for safe and convenient surgical care options," Dr. Sutaria said. "We believe adding centers with strong margins and attractive post-synergy multiples remains the most effective use of our cash for investments to enhance Tenet's earnings and free cash flow."
The company has grown nearly 126% since 2011, when it had 204 ASCs in its portfolio. USPI's growth began to skyrocket in 2021, when Tenet said it would acquire more than 90 ASCs from SurgCenter Development for approximately $1.2 billion. At the end of the second quarter in 2022, Tenet paid $406 million to acquire Dallas-based Baylor Scott & White Health's 5 percent equity position in USPI.
In 2023, USPI added 30 ASCs and has more than 30 in development. USPI plans to inject $200 million to $250 million in ASC mergers and acquisitions a year and maintain a pipeline to support that level of investment.
"The pipeline is very robust at this stage and healthy, inclusive of both single centers and platforms that have multiple centers within it, a good mix of acuity across different services, meaning orthopedics and other things," Dr. Sutaria said.