While independent ASCs have a steady hold on the market, with 68.1% of centers being freestanding, big chains continue to grow their market share as healthcare continues to consolidate.
Here's a breakdown on the three biggest ASC operators by market share:
United Surgical Partners International
With 7.1% of the ASC market share, Dallas-based Tenet Healthcare's USPI is the largest ASC chain by number of physicians and centers and has seen massive growth in the last few years.
"We see a tremendous opportunity with our ambulatory platform," Tenet CEO Saum Sutaria, MD, said, speaking May 14 at the Bank of America Securities 2024 Health Care Conference. "We're in this unique space of innovation and ambulatory care growth, which creates a significant amount of value and savings for the system, but it's also unique in the sense that it's value-based care that actually creates value for shareholders.
As of 2024, USPI has 512 ASCs and 25 surgical hospitals spanning 38 states in its portfolio. This growth will likely continue as Tenet plans to invest $450 million into its ambulatory business in 2024. In the first quarter, it acquired 45 ASCs, while selling nine hospitals for proceeds of $4 billion.
"We're really happy with the pipeline that we see looking forward. There are significant numbers of opportunities and high quality assets," Dr. Sutaria said, adding that there are still de novo projects in the works that will open over the next couple of years.
Tenet acquired more than 90 ASCs from SurgCenter Development for approximately $1.2 billion in 2020, paving the way to market dominance. USPI has grown nearly 126% since 2011, when it had 204 ASCs in its portfolio. By the end of 2019, USPI overtook AmSurg as the largest ASC chain in the country.
SCA Health
Optum's SCA Health is the second largest ASC chain, with 320 centers in 2023 and 5.3% of ASC market share.
Optum acquired SCA Health for $2.3 billion in 2017. In 2023, SCA Health acquired at least two cardiovascular providers — National Cardiovascular Partners and Pivotal Healthcare. In May 2022.
Optum, the country's largest employer of physicians, is focusing on physician deals and has spent $31 billion on acquisitions in the last two years. The group added 20,000 physicians in 2023 and inked three major physician group acquisitions.
AmSurg
AmSurg, formerly owned by Envision Healthcare until its bankruptcy last year, has 256 ASCs in its portfolio and 4.1% of ASC market share.
"I appreciate the collaboration with Envision leaders that has brought us to this point," AmSurg CEO Jeff Snodgrass said in an Oct. 11 news release. "We have built strong momentum as an organization that will propel our path to growth. I look forward to AmSurg's next chapter and am grateful for the efforts of our teams, centers and physician partners that drive our success."
This month, AmSurg acquired Las Vegas-based Alta Rose Surgery Center in partnership with Comprehensive EyeCare Partner and established a joint venture with Escondido, Calif.-based Palomar Health's Poway Surgery Center.