12 largest ASC chains in the US

Here are the 12 largest ambulatory surgery center chains in the United States by the number of ASCs each chain has.

Please contact Laura Dyrda at ldyrda@beckershealthcare.com with any questions on this list.

Tenet/USPI (470). Tenet acquired 50.1 percent of United Surgical Partners International last year with a path toward full ownership. At the time of the acquisition, Tenet refinanced $1.5 billion USPI debt and paid $404 million to pre-existing USPI shareholders. USPI combined its 49 ASCs and 20 imaging centers with Tenet’s facilities at that time. As of the first quarter of 2016, Tenet reported operating 470 outpatient centers in the United States. Tenet’s ambulatory segment reported $429 million net operating revenue in the first quarter of 2016 and same-facility systemwide revenue increase of 11 percent. The same-facility systemwide cases increased 8.6 percent and revenue per case was up 2.2 percent.

AmSurg (256). Focused on gastroenterology and ophthalmology ASCs, AmSurg reported operating 256 ASCs and one surgical hospital at the end of the first quarter. The company merged with two ASCs during the quarter and received a letter of intent for six ASCs and one other was under development, expected to open late this year. The company’s ambulatory services revenue was up 8 percent to $307.1 million for the quarter and same-center revenue increased 8.8 percent. Since acquiring Sheridan for $2.35 billion, AmSurg has brought several other anesthesiology practices under its umbrella. The full company’s net revenues were up 27 percent in the first quarter to $724.7 million. Christopher Holden is CEO.

Surgical Care Affiliates (198). As of May 3, Surgical Care Affiliates reported 198 facilities. The company acquired three new facilities in the first quarter and has partnered with others in the second, including Thomas Johnson Surgery Center in Frederick, Md., and Grove Place Surgery Center in Vero Beach, Fla. The company also signed a letter of intent with a Blue Cross plan in the first quarter to acquire and build a high-value surgical network. SCA’s total net operating revenue increased 19.5 percent in the first quarter to $279.9 million. Systemwide net patient revenue for the first quarter was up 10.1 percent and systemwide case volume jumped 8.3 percent. Andrew Hayek is the CEO.

Hospital Corporation of America (116). HCA is one of the largest healthcare companies in the United States, comprised of 169 hospitals and 116 freestanding surgery centers in 20 states and the United Kingdom. Founded by Thomas Frist, Sr., MD, Thomas Frist, Jr., MD, and Jack Massey, HCA includes 37,000 physicians and 233,000 employees. R. Milton Johnson currently holds the position of chairman and CEO of the company, while Greg Beasley is president of HCA's ambulatory surgery division.

Surgery Partners (96). Surgery Partners has 96 ASCs across the country. The company has grown organically as well as through acquisitions of NovaMed for $214 million and Symbion for $7.292 million over the years. In the first quarter of 2016, Surgery Partners reported same-facility revenue increased 13.3 percent over the same period last year to $259.7 million. The overall company revenue jumped 19.2 percent to $267.1 million. In the first quarter, the company completed three in-market transactions and particularly focused on growth in northeast Florida. The company also has a network of around 48 physician practices. Michael Doyle is the CEO.

SurgCenter Development (94). SurgCenter Development has 94 operational ASCs and 12 centers in development. The company partners with local surgeons to create physician-owned and operated ASCs throughout the United States. Physician partners maintain majority ownership while SurgCenter Development is a vested partner with 38 percent ownership in the center. The company also provides consultative and management services to members.

Physicians Endoscopy (42). Physicians Endoscopy was established in July 1998 and currently operates 42 surgery centers. The management and development company partners with gastroenterologists and focuses on freestanding, single-specialty endoscopic ASCs. The company offers flexible acquisition models as well as strategic alignments with hospitals. Barry Tanner serves as the company's CEO, while Karen Sablyak is the CFO.

Covenant Surgical Partners (28). Covenant Surgical Partners owns and operates a national network of 28 ASCs. The company also operates several anesthesia entities across multiple states as well as two anatomic pathology laboratories. The company offers management services as well as financial and administrative support. The company's president and CEO is Rick Jacques. Jeff Fisher serves as vice president and CFO.

Regent Surgical Health (25). Established in 2001, the company develops and manages ASCs. Of its 25 ASC partnerships, 16 are hospital joint ventures. The company also works with struggling surgery centers, offering turnkey solutions to ensure success. The privately held company is led by Chris Bishop, CEO, and Matt Lau, CFO. Thomas Mallon and W. Michael Karnes are the company's founders.

ASD Management (23). ASD Management includes 23 surgery centers in partnership with physicians or as physician/hospital joint ventures. The company has worked with hundreds of ASCs since its inception in 1986 to strengthen business operations and generate continuous revenue from the market. Partners Robert Zasa and Joe Zasa leverage their expertise to generate physician growth and investment. They work with ASCs on turnarounds, joint ventures and ASC development.

Proliance Surgeons (22). Proliance Surgeons has 22 ASCs and one currently under construction. The practice has 200 board-certified physicians and more than 100 care centers across Washington state. Specialties treated include orthopedics, sports medicine, ENT, general surgery, urology and more. David Fitzgerald is the CEO. He recently spoke on Capitol Hill briefing about a study showing ASCs can reduce outpatient surgery costs for commercially insured patients by $38 billion annually.

Surgical Management Professionals (20). The company operates 20 ASCs throughout the nation. Established in 2004, the company offers facility development, day-to-day operational management and revenue cycle services, such as coding, billing and collections. Michael Lipomi serves as SMP's president and CEO, and R. Blake Curd, MD, is the board of directors' chairman.

Ambulatory Surgical Centers of America (16). Ambulatory Surgical Centers of America currently operates 16 facilities across the country. The company was founded in 1984, and its goal is to partner with physicians to successfully establish and manage an ambulatory care facility. Its centers average 40 percent EBITDA. Luke Lambert is the current CEO of the company and he was among the first in the industry to earn the Certified Administrator Surgery Center credentialed designation.

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