The nation’s five largest ASC companies — United Surgical Partners International, AmSurg, Surgery Partners, HCA Surgery Ventures and SCA Health — have made major moves in 2025, from billion-dollar revenue gains and guidance raises to acquisitions and consolidation.
Together, their strategies highlight the continued shift toward higher-acuity outpatient care and the growing scale of the ASC market.
- USPI added eight ASCs in the second quarter of 2025 and raised 2025 guidance after a strong second quarter; Tenet now projects USPI adjusted earnings before interest, taxes, debt and amortization of $1.99 billion to $2.05 billion.
- First-quarter 2025 revenue hit $1.2 billion, up from $995 million year over year, as USPI continued shifting toward higher-acuity cases.
- USPI is sharpening its focus on orthopedic-driven centers and moving away from lower-acuity, high-volume procedures.
- Ascension entered a definitive agreement to acquire AmSurg, vaulting the health system into a top-tier ASC competitor.
- Earlier in 2025, AmSurg continued tuck-in acquisitions, including a majority stake in Texarkana (Texas) Surgery Center, as part of a broader growth push.
- Q2 2025 revenue reached $826.6 million (up 8.4% year over year); same-facility revenue rose 5.1% and cases 3.4%; adjusted EBITDA climbed 9% to $129 million; fiscal 2025 guidance was reaffirmed.
- Surgery Partners also rejected a buyout proposal from Bain Capital, signaling confidence in its independent growth strategy.
- Freestanding ASC count rose to 124 in Q2 2025; outpatient services accounted for 38.4% of total patient revenue as HCA’s ambulatory mix continued to grow.
- Same-facility outpatient surgeries dipped 0.6% (inpatient fell 0.3%) in Q2, while HCA raised full-year 2025 revenue outlook to $74 billion and $76 billion.
- Optum-owned SCA Health acquired U.S. Digestive Health, adding 24 ASCs and more than 40 GI practice sites in Pennsylvania and Delaware to its platform.
- The company also closed Perimeter Surgery Center in Atlanta, consolidating services into a nearby outpatient site as part of its ongoing footprint realignment.
