10
ASC
MANAGEMENT
8 executive insights from USPI, Surgery
Partners, HCA
By Patsy Newitt
U
nited Surgical Partners International, Surgery Partners and
HCA Healthcare are three of the largest ASC chains in the
U.S.
Here are insights from their top executives on their strategies for
2022 and beyond:
United Surgical Partners International
Transactions: Dallas-based USPI ended the year strong. e
company completed a large acquisition of SurgCenter Develop-
ment and its more than 90 ASCs for about $1.2 billion and acquired
ownership and management interests in nine ASCs from Compass
Surgical Partners.
In an Oct. 21 third-quarter earnings call transcribed by e Motley
Fool, Saum Sutaria, MD, CEO of parent company Tenet Healthcare,
attributed much of USPI's success to its ownership model.
e model allows the company to "deploy capital on both mature
centers and centers that are still developing, but actually generate
returns faster as a better natural owner that is going to expand the
set of opportunities for us at USPI," he said.
Higher-acuity procedures: e company sharpened its focus on
higher-acuity cases, both in its ASCs and hospitals. Tenet's ortho-
pedic services saw growth rates up 22 percent in the third quarter,
compared to the same period last year, Ronald Rittenmeyer, execu-
tive chairman, said in the call.
Additionally, USPI has completed more than 535,000 musculoskel-
etal procedures to date, and joint replacement surgeries have more
than doubled from 2020.
"We remain focused on executing our strategy of delivering high-
acuity services for both emergent and elective basis," Mr. Ritten-
meyer said in the call.
Physician growth: USPI has also added more than 1,700 phy-
sicians in 2021.
"It's important to note that these are independent physicians choos-
ing to come and work at our facilities," Mr. Rittenmeyer said. "Our
acquisition pipeline remains active as we partner with physicians
and health systems in attractive markets."
Surgery Partners
Brentwood, Tenn.-based Surgery Partners grossed $320.9 million in
closing its underwritten public offering of 6.9 million shares, beating
its projection.
Physician growth: Surgery Partners is remaining focused on physi-
cian growth, adding 10 percent new physicians to its facilities in
2021, executive chairman Wayne DeVeydt said in a Nov. 2 third-
quarter earning call transcribed by e Motley Fool.
"We continue to see new and increased physician demand for our
short-stay surgical facilities, and our targeted recruitment approach
remains focused on attracting the highest quality physicians," CEO
Eric Evans said in the call.
Total joint replacements: In 2021, Surgery Partner's total ASC joint
replacements increased about 108 percent compared to the prior
year, Mr. Evans said. is growth was led by CMS total joint proce-
dures, which grew by about 300 percent.
Robotics cases are also up by more than 60 percent last year at
14 of the company's ASCs with 34 total robots deployed across
its facilities.
"We've made it to become a national leader in outpatient total joint
procedures in our ambulatory surgery centers," Mr. Evans said.
"While ASC total joint procedures still represent a small portion of
our overall case mix, they are an important and fast-growing part of
our value proposition to consumers, providers and payers."
Cardiology: e company is also focusing on a longer-term oppor-
tunity in cardiology, considered one of the biggest opportunities for
growth in the ASC industry.
In 2021, Surgery Partners revitalized cardiology programs at four
ASCs and one surgical hospital, with plans to expand to another six
locations in 2022, Mr. Evans said.
"Our ASC focus to date is in cardiac rhythm management proce-
dures, including pacemakers, [implantable cardioverter defibrillator]
implants and replacements and loop recorder implants," Mr. Evans
said. "But we're also looking at expansions into higher-acuity inter-
ventions to include [percutaneous coronary intervention], as those
procedures were approved by CMS for ASCs [in 2020]."
HCA Healthcare:
Nashville, Tenn.-based HCA Healthcare reported strong growth in
outpatient revenue and profit in the third quarter of 2021.
Outpatient investment: Outpatient revenue was 34.1 percent of all
patient revenue for the quarter. e company reported a 7.2 percent
increase in outpatient surgery cases in the third quarter from the
same period last year.
"Our development pipeline of new outpatient facilities is robust, and
we fueled that with investment," HCA CEO Sam Hazen said in an
Oct. 22 third-quarter earnings call transcribed by e Motley Fool.
"We have a strong pipeline of projects that will come online in 2022
and 2023 that are connected to both our hospital platform as well as
our outpatient platform."
Physician platform growth: e company has also added to its physi-
cian platform over the past two years, through both the development
of existing practices and new acquisitions.
"Inside of our physician platform, we do see opportunities to con-
tinue to push further into value-based care," Mr. Hazen said. "In that
particular platform in our company, we have aspects of value-based
care. ey vary a little bit from one market to the other depending
on the circumstances and the demographics and payer dynamics in
those markets." n
