Ambulatory Surgery Centers

Industry Profile Report

Dive Deep into the industry with a 25+ page industry report (pdf format) including the following chapters

Industry Overview Current Conditions, Industry Structure, How Firms Operate, Industry Trends, Credit Underwriting & Risks, and Industry Forecast.

Call Preparation Call Prep Questions, Industry Terms, and Weblinks.

Financial Insights Working Capital, Capital Financing, Business Valuation, and Financial Benchmarks.

Industry Profile Excerpts

Industry Overview

The 5,900 ambulatory surgery centers (ASC) in the US provide facilities and services to physicians to perform medical procedures that do not require an extended patient recovery period. Common services include eye procedures, endoscopies, biopsies, pain management treatments, and orthopedic procedures. Physicians have some type of ownership interest in about 93% of ASCs. Through joint ventures, hospitals have ownership interest in at least 28%.

Dependence upon Insurers

ASCs derive the majority of their revenue from third-party payers, including private insurers, managed care systems, and government sources, such as Medicare and Medicaid.

Legislation Targets Physician-Owned Centers

Amendments to Stark laws, which prohibit self-referrals for Medicare and Medicaid beneficiaries, limit growth opportunities and could significantly change ownership structures for ASCs.

Industry size & Structure

A typical ASC operates out of a single location, employs about 30 workers, and generates $7.3 million in annual revenue.

    • The ASC industry consists of about 5,900 companies which employ 176,300 workers and generate $43.1 billion annually.
    • There are about 7,600 freestanding ASCs in the US. Of these, around 72% are Medicare-certified facilities.
    • Physicians have some type of ownership interest in about 93% of ASCs. Through joint ventures, hospitals have ownership interest in 28%. Only 3% of ASCs are owned entirely by hospitals.
    • About 25-30% of ASCs are owned by multiple facility chains.
    • Large companies include Amsurg, United Surgical Partners, Surgical Care Affiliates, HCA, NueHealth, and Surgery Partners.
                              Industry Forecast
                              Ambulatory Surgery Centers Industry Growth
                              Source: Vertical IQ and Inforum

                              Recent Developments

                              Jan 9, 2025 - Staffing, Supply Management Are Key Issues
                              • Ambulatory surgery centers (ASCs) are concentrating on staffing and supply management to ensure a well-run and profitable surgery center, according to Sandra Jones, founder and President of Ambulatory Strategies. Increasingly complex regulations and roadblocks to compliance with federal requirements also demand more planning and persistence. This is resulting in more ASCs and in smaller ASC management companies reaching out for help to achieve efficiency and regulatory compliance, according to Jones.
                              • US juries ordered companies in 47 different industries to pay a nuclear verdict — a jury award exceeding $10 million — in 2023, according to Marathon Strategies. Awards in some healthcare cases have reached high eight- or nine-figure sums, according to Bloomberg Law, as seen in recent lawsuits by Radiology Partners and Envision Healthcare against UnitedHealthcare. There were 89 cases with verdicts of more than $10 million in the US, the highest in 15 years and a 27% increase since 2022. Of those, 27 cases topped $100 million, eight topped $500 million, and two were in excess of $1 billion. The latter are referred to as “thermonuclear verdicts.”
                              • The Centers for Medicare and Medicaid Services (CMS) issued a final rule through which ambulatory surgical centers (ASCs) will get a 2.9% Medicare reimbursement increase in 2025, up from the 2.6% increase floated in the draft rule. The increase will affect approximately 6,100 ASCs, according to CMS.
                              • Ambulatory surgery center industry employment increased slightly and average wages for nonsupervisory employees increased moderately during the first 10 months of 2024, according to the US Bureau of Labor Statistics (BLS). Ambulatory surgery centers sales are forecast to grow at a 5.1% compounded annual rate from 2024 to 2028, faster than the growth of the overall economy.
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