Independence Blue Cross’ move into ASC ownership shows how far commercial payers have come on site-of-service shifts. Daniel Tasset, founder, CEO and executive chairman of Leawood, Kan.-based NueHealth, sees the next step somewhere else: payers asking providers to guarantee results.
Philadelphia-based IBX, Penn Medicine and Franklin, Tenn.-based Regent Surgical announced Sept. 24 that they formed a company to develop at least 18 ASCs across Greater Philadelphia and Penn Medicine’s service area in Pennsylvania, New Jersey and Delaware. All three organizations are owners.
IBX said the partnership is about adding capacity.
“Contracting remains an important part of Independence Blue Cross’ strategy, but that alone won’t create new capacity,” an IBX spokesperson told Becker’s. “That’s why we partnered with Penn Medicine and Regent Surgical to help build additional capacity and expand access to high-quality, affordable care across Greater Philadelphia.”
The spokesperson said the structure aligns the organizations that deliver, operate and pay for care.
“No one organization can solve healthcare’s biggest challenges alone,” the spokesperson said. “What makes this partnership unique is that the organizations that deliver care, operate care sites and pay for care are all working toward the same goal: helping patients get the care they need in convenient, affordable settings.”
Regent CEO Travis Messina told Becker’s the company has never had a payer take an ownership stake in one of its ventures. He believes it is the first ASC partnership to include a health system, a health plan and a management company. He said a payer’s perspective “warrants itself to be present at the partnership table.”
IBX isn’t the first payer company to own surgery centers. UnitedHealth Group’s Optum acquired Surgical Care Affiliates in 2017 for $2.3 billion. Nearly a decade later, SCA Health is one of the country’s largest ASC operators, with more than 320 ASCs as of 2025. UnitedHealth Group now employs or contracts with more than 90,000 physicians. The latest Sunlight Report from the Center for Health & Democracy counts 689 entities under SCA Health.
Mr. Tasset said he doesn’t expect payer ownership to be where the market goes next.
“I don’t think insurance companies owning part of the surgery center is the next phase,” he told Becker’s. “I think the site-of-service shift has already been embraced. The next phase is for the insurance companies to say, ‘We would like for the providers to guarantee their product, to take substantial downside risk.’”
Mr. Tasset said NueHealth’s own work with IBX helped show the payer the value of ASCs. The Orthopaedic Surgery Center at Bryn Mawr Hospital in suburban Philadelphia, a joint venture of NueHealth, Main Line Health and Rothman Orthopaedics, signed what he described as a “programmatic savings” contract with IBX, not a downside-risk arrangement. Over the life of that contract, the center has performed between 1,500 and 2,000 total joint replacements and saved IBX close to $50 million, he said.
NueHealth wants to go a step further. Its model brings the surgery center, surgeons, anesthesia providers and physical therapy together in an episodic bundle that guarantees clinical quality, total cost and patient satisfaction. In Mr. Tasset’s view, payers can get those savings through contracts rather than equity.
He said the company has started pitching the model to Chicago-based Health Care Service Corp., the parent company of Blue Cross and Blue Shield of Illinois, as well as Blue KC, Highmark and Horizon Blue Cross Blue Shield of New Jersey.
“They’re starting to listen, but it’s hard,” he said.
Mr. Tasset compared the pitch to the early days of ASC contracting, when payers wouldn’t sign with a center that didn’t exist yet.
“The payers are not going to give a contract to an idea,” he said. “We have to have a facility and a network and the technology to support it, so that we can do prospective downside-risk episodic bundles with the payer.”
He said the model requires aligned surgeons and anesthesia providers, technology to run clinical pathways and a captive insurance arrangement that shows payers the network can back a guarantee. NueHealth redesigned Kendall Pointe Surgery Center in Oswego, Ill., a physician-owned ASC it manages, with that model in mind. The center reopened Sept. 1 after a more than $3.5 million expansion that added a fourth operating room.
Mr. Tasset credits self-funded employers and intermediaries such as Healthcare Highways, Lantern, Carrum Health and Transcarent with pushing commercial payers to move. Those companies have built carve-outs for total joints, spine and orthopedics that he said payers have yet to match.
“Things happen gradually, and then all of a sudden,” Mr. Tasset said. “And I think all of a sudden is here.”
Federal policy is moving the same way. Mr. Tasset pointed to CMS’ Ambulatory Specialty Model as a sign of where it is heading. Starting Jan. 1, 2027, the model will hold certain specialists accountable for Medicare patients with low back pain or heart failure through two-sided payment adjustments.
Pressure on site of care is also building. CMS began phasing out the inpatient-only list in 2026, removing 285 mostly musculoskeletal procedures in the first year. Elevance Health said Sept. 29 it will require hospitals to list where care was delivered on claims and will pay certain off-campus services at off-campus rates.
Mr. Messina said the inpatient-only list phaseout helped bring IBX to the table.
“The removal of the inpatient-only list and the need to create access, convenience and more affordability for patients really kind of accelerated the timing,” he said.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
