ASC company 2018 outlook: 18 key notes

Here are 18 things to know about the 2018 outlook from four large ASC chains.


1. Envision, AmSurg's parent company, currently owns and operates 264 surgery centers nationwide. The company reported $132.6 million in net income for the fourth quarter and same-center revenue grew 2.7 percent.

2. The company expects to realize net revenue of $8.35 billion to $8.53 billion for 2018, with same-center revenue growth for ambulatory services growing 1 percent to 2 percent over the next year.

3. Early in the year, rumors spread that UnitedHealthcare was interested in acquiring AmSurg, Envision's ambulatory unit. However, Envision has since sued UnitedHealthcare over payment issues, alleging the insurer lowered contract payments to its physicians and didn't add new Envision physicians to its insurance network.

4. AmSurg has undergone major acquisitions, including Sheridan Healthcare to strengthen physician services, but surgery centers still remain a core focus. Last April, the company celebrated its 25th anniversary and reported its physicians performed more than 12 million procedures in the 10 years prior.

5. Envision reported same-contract revenue growth for physician services is expected to grow 1 percent to 4 percent this year.

Surgery Partners

1. In the future, Surgery Partners plans to deploy $80 million to $100 million of capital per year on mergers and acquisitions at industry multiples. The company also has planned divestitures and is evaluating its entire portfolio to divest assets that aren't core to its long-term strategy.

2. The company has already bolstered its leadership team, bringing on a new CEO, chief strategy and transformation officer and chief human resource officer; the company is also looking for a CFO. "In many respects, 2018 will be an investment year to ensure that we have the right people and processes in place to drive our business in the medium and long-term," said CEO Wayne DeVeydt during the annual conference call, according to a Seeking Alpha transcript.

3. Surgery Partners acquired National Surgical Health at the end of 2017 and will continue to work on the combination this year; the company has identified opportunities to add immediate value to Surgery Partners in the second half of the year.

4. The company expects revenue to exceed $1.75 billion in 2018 and EBITDA to be greater than $240 million.

5. In the near term, Surgery Partners is focused on payer alignment and physician recruitment to achieve its goals this year and set the company up to realize additional success in 2019 and beyond.

Surgical Care Affiliates

1. Surgical Care Affiliates merged with Optum to become OptumCare in 2017; at the year's end, OptumHealth grew 21.7 percent year-over-year to report $20.6 billion in revenue.

2. SCA added six ASCs from January to October 2017 and plans to continue growing in 2018. The company reported a 10 percent investment in a new Portland, Ore.-based ASC at the end of last year in partnership with Providence Health & Services. Construction is expected to begin in April.

3. Optum is expected to report revenue between $99 billion and $100 billion in 2018.


1. Overall, USPI's parent company Tenet raised its yearlong outlook to expect revenue between $17.9 billion and $18.3 billion. The ambulatory segment reported nearly 7.5 million outpatient visits in 2017, a 2.6 percent decrease over 2016. Net outpatient revenue hit $5.6 million, a 3.2 percent increase.

2. The company expects net income attributable to shareholders between $95 million and $105 million.

3. In the fourth quarter of 2017, USPI's same-facility systemwide revenue grew 6.9 percent and the company expects to continue looking for partnerships in the ambulatory space. "The performance of USPI continues to exceed our expectations and I was very pleased particularly with the strong results in imaging and urgent care visits," said CEO Ronald Rittenmeyer. "In addition, opportunities are ripe on the development side thanks to the hard work of the USPI team, and we completed five new health system joint ventures last year."

4. USPI will continue to expand upon its partnership with New York City-based Hospital for Special Surgery on an orthopedic facility in West Palm Beach, Fla. Mr. Rittenmeyer reported to Fortune the company is in discussions for similar projects with other health systems this year and beyond.

5. Tenet's overall company has gone through a leadership shakeup. The company eliminated its executive committee and changed shareholder requirements; shareholders aren't required to hold a majority of outstanding common stock to call a special meeting, and the threshold was reduced to 25 percent of the outstanding common stock.

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