Did the ASC industry end the year with a bang or a bust? 50 things to know about 4Q, year-end financial results

The ambulatory surgery center industry has experienced in an uptick in consolidation over the past year, but did the major players in the industry end 2014 on a financial high note? Here are 50 things to know about the fourth quarter and year-end financial results from eight key ASC companies.

AmSurg
AmSurg acquired Sheridan Healthcare last year and continues to move forward with diversifying its portfolio. The company already acquired two radiology groups this year. AmSurg's strategy appears to be effective; the company reported positive fourth quarter and year-end financials.

1. AmSurg reported net revenues of $581.8 million for the fourth quarter, up 108 percent from the fourth quarter of 2013. The company's net earnings from continuing operations attributable to common shareholders was $25.3 million, adjusted net earnings of $39.6 million, up 95 percent from the same period in 2013.

2. The company's adjusted EBITDA for the fourth quarter was $111 million, up 123 percent from the fourth quarter of 2013.

3. Net revenues for 2014 were $1.62 billion, up 53 percent from 2013. Adjusted net earnings increased 53 percent to $114.2 million.

4. AmSurg's ambulatory surgery revenues rose 6 percent in the fourth quarter to $295.7 million. During the quarter, the company acquired four ambulatory surgery centers, including one acquired in conjunction with the Sheridan transaction.

5. Over the course of 2014, the company acquired 10 centers in total. AmSurg closed out the year with 246 centers. Five centers were under letter of intent, one that has since been required. Two additional centers are under development.

6. At the end of 2014, the company had cash and equivalents of $208.1 million. For the full-year 2014, AmSurg had net cash flow from operations, less distributions to non-controlling interests and excluding transaction-related costs, of $267.3 million.

7. Physician services net revenues were $286.1 million for the fourth quarter of 2014. Revenue growth compared to the fourth quarter of 2013 was 7.2 percent.

8. For the first quarter of 2015, AmSurg expects revenues for the same-center revenue to grow 1 percent to 3 percent for ambulatory services. The company also expects 5 percent to 7 percent organic revenue growth in physician services.

Foundation HealthcareFoundation Healthcare
Foundation Healthcare reported positive financial results for both its fourth quarter and 2014.

9. Foundation HealthCare reported $31.1 million in net revenues for the fourth quarter, up 20 percent from $26 million in the same period in 2013.

10. In the fourth quarter, the company's patient services revenue increased 19 percent from $23.3 million to $27.8 million.

11. The company's fourth quarter operating expenses were $28.5 million, up from $26.9 million in the fourth quarter of 2013.

12. Adjusted EBITDA for the fourth quarter was $4.5 million, up from $3.4 million in the fourth quarter of 2013.

13. Foundation HealthCare's 2014 revenue increased 12 percent from $93.1 million in 2013 to $104.3 million.

14. The company's 2014 patient services revenue was $90.6 million, up 18 percent from $77 million in 2013.

15. Operating expenses for the year were $101.2 million, down from $112.6 million in 2013.

16. Foundation HealthCare's adjusted EBITDA for 2014 was $10.4 million, compared to $9.4 million in 2013.

Hospital Corporation of America
HCA reported positive financial and operating results for both the fourth quarter and the year.

17. HCA reported $9.6 billion in total revenues for the fourth quarter of 2014, up from $8.8 billion in the last quarter of 2013.

18. The company's same facility admissions increased 5 percent in the fourth quarter, compared to the prior year period.

19. HCA's net income for the fourth quarter was $527 million, up from $424 million in the same period in 2013.

20. The company's revenues for 2014 were $36.9 billion, up from $34.2 billion in 2013.

21. HCA projects that its 2015 revenue will be between $38.5 billion and $39.5 billion.

22. As of Dec. 31, 2014, HCA operated 113 freestanding surgery centers.

Medical Facilities Corporation
MFC reported relatively flat financial results, with a slight increase in 2014 revenue and dips in income and revenue for the fourth quarter.

23. MFC reported consolidated facility service revenue of $311.8 million for 2014, a 0.9 percent increase from $309.2 million in 2013.

24. Consolidated facility service revenue for the fourth quarter of 2014 was down 2.2 percent from $89.6 million in the fourth quarter of 2013 to $87.6 million.

25. Consolidated income from operations for the year was $71.2 million, down 2.8 percent from $73.3 million in the prior year period.

26.  For the fourth quarter, consolidated income from operations was $24.4 million, down 2 percent from $24.9 million in the fourth quarter of 2013.

27. For the full-year, cash available for distribution increased 1.3 percent to Cdn$41.4 million.

28. MFC owns controlling interests in an ambulatory surgery center and five specialty surgical hospitals.

Nobilis Health
Northstar Healthcare rebranded as Nobilis Health following the $34 million acquisition of marketing company Athas Health. Now, the company has reported significant gains for its fourth quarter and full year.

29. Nobilis Health reported $84 million in total revenues for 2014, up 170 percent from $31.1 million in 2013.

30. Total cases for the year increased 59.3 percent, from 5,486 cases in 2013 to 8,740 cases in 2014.

31. Cash flows from operating activities for the full year were $4 million, up $0.5 million from 2013.

32. As of Dec. 31, 2014, Noblis Health had $23.8 million, including $7.6 million in cash, of consolidated networking capital, compared to $8.7 million, include $5.6 million in cash, in 2013.

33. Total revenues for the fourth quarter increased 193.3 percent to $39.6 million.

34. Total cases for the quarter were 3,697, an increase in 104.1 percent.

35. The company reported adjusted EBITDA of $8.1 million, up from $3.5 million in the prior year period.  

Surgical Care Affiliates
SCA has had a busy year thus far. The company partnered with The CORE Institute and a group of independent physicians to open a surgical hospital and announced pricing of its secondary public offering of common stock. SCA ended the quarter and the year with positive financial results.

36. SCA reported $247.2 million in total net operating revenues for the fourth quarter, excluding revenues from facilities in which the company owns a non-controlling interest, up 15.6 percent from $213.8 million in the prior year period. The increase was driven by acquisitions, higher acuity case mix and a number of improved payer contracts.

37. System-wide net operating revenues, including all facilities in which SCA owns an interest, increased 9.9 percent in the fourth quarter.

38. The company's adjusted net income for the fourth quarter was $27.9 million, up from $17.6 million in the fourth quarter of 2013.

39. SCA's total net operating revenues for 2014, excluding revenues from facilities in which the company owns a non-controlling interest, increased 10.1 percent from $785.7 million in 2013 to $864.7 million.

40. The company's system-wide net operating revenues for the full year, including all facilities in which SCA owns an interest, increased 10 percent. Adjusted net income for the full year rose 69.8 percent from $48 million in 2013 to $81.5 million.

41. During the fourth quarter, SCA added six facilities, three of which were consolidated, two of which were non-consolidated and one which was managed-only. After the close of the year, SCA added an additional four facilities. As of March 10, SCA has 190 facilities.

Tenet Healthcare
Tenet was at the forefront in the most recent major ASC industry transaction. The company plans to form a joint venture with United Surgical Partners International. Before announcing this deal, Tenet finished its fourth quarter with strong financial results.

42. Tenet reported net income of $61 million for the fourth quarter, compared to a net loss of $24 million in the final quarter of 2013.

43. The company reported net operating revenues of $4.5 billion in the quarter ended Dec. 31, 2014, up from $3.9 billion in the fourth quarter of 2013.

44. Tenet's after-tax income from continuing operations was $104 million, or $1.03 per diluted share, for the fourth quarter of fiscal 2014, compared to $43 million, or $0.43 per diluted share, in the comparable quarter of the previous year.

45. Tenet expects its adjusted earnings per share for fiscal 2015 to be in a range of $1.32 to $2.40 per share.

United Surgical Partners International
USPI is poised to become part of the largest ASC company in the industry, once the Tenet joint venture is finalized. The company reported positive fourth quarter and year-end financial results across the board.

46. USPI reported net revenues of $174.7 million for the fourth quarter, up 6 percent from $164.9 million in the fourth quarter of 2013. The company's operating income for the fourth quarter increased 5 percent from $81.9 million in the prior year period to $86.1 million.

47. USPI had cash flows from operating activities of $51.7 million for the fourth quarter, up from $31.8 million in 2013.

48. USPI's net revenues for 2014 increased 4 percent from $616.2 million in 2013 to $640.8 million this year. Operating income for 2014 was $269.8 million, up 2 percent from $263.8 million in the prior year period.

49. Cash flows from operating activities were $211.6 million for 2014, compared to $159.9 million in 2013.

50. USPI acquired interest in two centers during the fourth quarter and interests in 10 facilities during the course of 2014.

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