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52 13th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine – Call (800) 417-2035 T wo of the biggest transactions in ambulatory surgery center industry history; feverish mergers and acquisition activity in the anesthesia sector; legislative upheaval: no one can argue that 2014 was a dull year for ASCs. Here are 10 of the biggest healthcare stories that impacted the ASC industry this year. 1. AmSurg acquisition of Sheridan. In May, AmSurg announced its in- tentions to acquire anesthesia provider Sheridan Healthcare. AmSurg closed the $2.35 billion cash and stock deal in July. "With the addition of Sheridan, we will be significantly diversified and differentiated — holding leadership positions in outsourced physician services for anesthesia, children's services, emergency medicine services and radiology," said AmSurg CEO Christopher Holden in a statement. The acquisition roughly doubled the size of AmSurg, which ended its sec- ond quarter with 243 centers. The transaction was significant not only for its sheer size, but it also marked the first time an ASC company made such a huge move to diversify its portfolio. 2. Surgery Partners acquisition of Symbion. In June, on the heels of the AmSurg-Sheridan announcement, Surgery Partners announced that it would acquire Symbion for $792 million. After the completion of the trans- action Surgery Partners will operate almost 100 ASCs in 27 states, propelling it into the ranks of some of the largest industry companies. "We are excited about the opportunity to expand the reach of our health- care delivery model…the acquisition of Symbion provides an opportunity to build a larger, diversified portfolio of assets while also offering a compel- ling integrated care model which drives efficiency by cost effective design. We look forward to supporting the needs of our new physician and employee partners at Symbion as they continue their successful expansion with us," said Mike Doyle, Surgery Partners CEO. After the announcement of the deal, various credit agencies offered their thoughts on the future of the combined companies. To finance the trans- action, Surgery Partners increased the size of two term loans. Standard & Poor's Ratings Service gave the company a stable outlook with a prediction of moderate cash flow and stable margins, but highlighted the possible risk associated with large scale integration. Moody's Investors Services gave post- acquisition Surgery Partners a 'B3' rating, indicating the company's high level of debt but a positive position in a growing industry. 3. Protecting Access to Medicare Act of 2014 & ICD-10 delay. On March 31, the U.S. Senate passed the Protecting Access to Medicare Act of 2014, which President Barack Obama signed into law shortly thereafter. In addition to serving as another sustainable growth rate patch, the law effec- tively postponed the switch to ICD-10 by at least a year. The law did not specify an exact deadline for the switch to the new code set. HHS did not release a final rule confirming Oct. 1, 2015 as the defini- The 10 Biggest ASC Industry Stories of 2014 By Carrie Pallardy In 1979 the Steelers won the Super Bowl. Saturday Night Fever was the album of the year. And AAAHC began accrediting ambulatory health care organizations. If you would like to know more about AAAHC accreditation, call us at 847-853-6060. Or email us at info@aaahc.org. Or you can visit our web site at www.aaahc.org. Improving Health Care Quality through Accreditation We've been raising the bar on ambulatory care through accreditation for 35 years. The secret of our success? Our peer review. AAAHC surveyors are physicians, nurses, anesthesiologists, medical directors and administrators. Which is why organizations routinely heap praise on us for our consultative and educational survey process. And why we are the leader in ambulatory accreditation. YEARS STRONG