Becker's ASC Review

28 TRANSACTIONS Meet the forces battling for ASC market share By Patsy Newitt W hile the ASC industry is largely fragmented, five major groups control a solid chunk of the market share, according to the VMG Health's "2023 Healthcare M&A Report." Here is what to know about the five biggest groups in the ASC industry: Tenet Tenet Healthcare, parent company of ASC chain United Surgical Partners International, is leading the charge in acquiring ASC market share. e health system's ASC portfolio includes more than 445 centers and 24 surgical hospitals — with 7.3 percent of total market share. USPI is the largest ASC chain in the country and employs more than 11,000 physicians, including 6,000 physician partners. Optum Optum, parent company of Deerfield, Ill.-based SCA Health, boasts about 320 ASCs and 5.3 percent of ASC market share. Aer SCA Health rebranded in May, the company began focusing more on physician group acquisitions over ASC acquisitions. Optum is the largest employer of physicians in the country, with a portfolio of 70,000. AmSurg AmSurg, which is a part of Envision Healthcare, controls 4.3 percent of the ASC market share. Following Envision's recent filing for bankruptcy, AmSurg plans to buy all of Envision's ASCs for $300 million as a part of a restructuring plan. With 256 centers, the company's portfolio remains a strong force in the ASC market. HCA Healthcare Nashville, Tenn.-based HCA Healthcare employs or is affiliated with more than 47,000 physicians and is also ramping up its ASC portfolio. With 2.5 percent of the market share, HCA comprises 2,300 ambulatory care facilities, including more than 150 ASCs, freestanding emergency rooms, urgent care centers and physician clinics Surgery Partners Surgery Partners, one of the largest ASC chains in the country, spent just under $250 million to acquire ASCs last year, and is planning for more in 2023. With 2.4 percent of the market share, Surgery Partners plans to grow its portfolio of 127 ASCs. n The decline of private practice physicians: 5 stats By Patsy Newitt Here are five numbers to know about trends regarding private practice: 13 percent: The decline in the number of physicians working in private practice between 2012 and 2022, according to a report from the American Medical Association. 80 percent: The number of physicians who own their practices who said the need to negotiate higher payment rates with insurance companies influenced their decision to sell their practice, according to the AMA report. 26 percent: The percentage of physicians working in private practice, according to an 2022 report from Avalere. 51.8 percent: The percentage of physicians working in practices with fewer than 10 physicians in 2022, according to the AMA report. 11,400: The number of physicians who left private practice and hospital employment in the second half of last year after the rate of hospital-employed physicians had been flat for 18 months, according to the Avalere report. n How USPI is carrying Tenet's growth By Patsy Newitt D allas-based Tenet Healthcare's ASC chain, United Surgical Partners International, is driving the company's growth with a 22.2 percent revenue increase in the second quarter year over year. "USPI's future is bright, and our capital deployment into this business will continue to grow and develop this portfolio," CEO Saum Sutaria, MD, said in a July 31 earnings call transcribed by Seeking Alpha According to the call, Tenet is raising its 2023 earnings outlook by $7.5 million to $385 million, which includes a $45 million raise for USPI. Additionally, USPI has increased its assumptions for same-facility case growth from 5 percent to 6 percent in 2023. USPI continues to focus on ASC mergers and acquisitions as well. The company added 12 ASCs in the second quarter and has more than 30 centers either in syndication stages or under construction. Additionally, it saw a 9.8 percent increase in same-facility net operating revenues compared to last year and a 6.9 percent increase in case volumes. According to Dr. Sutaria, USPI will continue to capitalize on ASC growth, seen with an aging population, patients seeking more convenient care access and a recovering healthcare ecosystem. n

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