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 4,600 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 35 workers, and generates $7 million in annual revenue.

    • The ASC industry consists of about 4,600 companies which employ 173,300 workers and generate $34.5 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

                              Feb 22, 2024 - Strong Sales Growth Expected
                              • Ambulatory surgery centers sales are forecast to grow at a 6.46% compounded annual rate from 2022 to 2027, faster than the growth of the overall economy. Employment decreased slightly during the first half of 2023 but rebounded in the second half, according to the US Bureau of Labor Statistics (BLS). Average wages for nonsupervisory employees decreased slightly during 2023, according to the BLS.
                              • Ambulatory surgical outcomes were significantly better on average at centers with relatively high volumes, according to an analysis of Medicare data by researchers at Children's Hospital of Philadelphia. Odds of hospital admission or emergency department visit within 7 days of an ambulatory surgical procedure were 21% greater in low- versus high-volume centers. The disparity was even greater for patients with multiple comorbidities. Such patients had nearly double the odds for admission or emergency care when orthopedic procedures were involved.
                              • Hospital outpatient department care cost significantly more than care delivered in an ambulatory surgery center or provider office setting, according to the results of a study conducted by Blue Health Intelligence, Blue Cross Blue Shield Association's (BCBSA) data analytics and software-as-a-service company. BCBSA cited the study results in announcing support for the implementation of site-neutral payments and fair hospital pricing policies. "Our analysis shows site-neutral legislation could save our patients, businesses, and taxpayers nearly $500 billion over 10 years," said David Merritt, senior vice president of policy and advocacy at BCBSA.
                              • Employers are anticipating another 7% increase in health care costs for 2024, according to the International Foundation of Employee Benefit Plans (IFEBP). “Plan sponsors have indicated that chronic health conditions have a considerable effect on their medical expenses. That ties to the data that disease management and wellness programs rank high in cost-management strategies.” said Julie Stich, vice president of content for the IFEBP.
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