Issue link: https://beckershealthcare.uberflip.com/i/1013711
25 JOINT VENTURES ASC chains own 28% of the market: 5 key trends to know By Laura Dyrda T he top ASC multi-state operators own around 28 percent of Medicare-cer- tified ASCs in the U.S., showing how fragmented the market remains today, according to VMG Health Intellimarker. Here are five key notes: 1. ASC industry consolidation is in full swing and will likely continue over the next few years. Over the past decade, Envision and AmSurg merged, Tenet purchased 95 percent ownership in United Surgical Partners International and Optum, a division of UnitedHealth Group, acquired Surgical Care Affiliates. H.I.G. Capital sold its equity stake in Surgery Partners in May 2017 to BCPE Seminole Holdings, a Bain Capital Private Equity affiliate. Around the same time, Surgery Partners acquired National Surgical Healthcare for $760 million. 2. Multistate ASC operator ownership growth has outpaced the number of overall new ASCs every year. Overall ASC growth has been flat over the past eight years, with just a 1 percent increase in the number of ASCs from 2010 to 2017. 3. As of December 2017, AmSurg reported 264 ASCs, the highest number re- ported by a public company. e remaining large companies reported: • USPI: 261 • HCA: 120 • SurgCenter Development: 106 • Surgery Partners: 106 Surgical Care Affiliates had 186 centers when Optum acquired it. 4. Smaller multi-site operators and ASC management companies have 509 centers across the U.S. all together. 5. Independent ASCs still make up around 72 percent of the 5,602 ASCs in the U.S., as of December 2017. n The brilliance of Chris Holden and AmSurg — 6 quick thoughts By Scott Becker Here are six thoughts on the evolution of AmSurg and its leader, Chris Holden: 1. Just three to four years ago, AmSurg was an ASC company that relied 90 percent-plus on ASC earnings for its revenue. 2. Mr. Holden and his board saw slower growth in that arena. They set out to transform the company into a physician services company as opposed to a surgery center. 3. They bought several physician services firms and transformed AmSurg. Envision now gener- ates its revenues from almost everything but ASCs, and Mr. Holden is director, president and CEO of Envision. Approximately 14 percent of revenues today are from ASCs. 4. This has not been an easy transition, but it was a bold and needed one. 5. Envision agreed to sell its company to KKR, a behemoth private equity firm, for $9.9 billion. Envision's board unanimously approved the acquisition, which is expected to close in the fourth quarter of 2018. If approved, Envision will become a privately owned company. 6. Kudos to Chris Holden and his insightful and bold efforts. n Elevating medicine through data insights. NDI is a non-disruptive, FREE program for outpatient surgical centers that provides real-time benchmarking for informed decision making. nebuladataintel.com/demo • 224-701-6046 Participation is free. Contact us today for a demo.