ASC industry snapshot: 22 things to know about 5 large companies

Here is a snapshot of five large ASC chains based on their second quarter financial report and earnings call.

Companies are listed in alphabetical order.

AmSurg, an Envision company
1. Net revenue: $328 million (3 percent increase)
2. Same-center revenue growth: 2.9 percent
3. Same-center volume growth: 1.5 percent
4. Same-center rate growth: 1.5 percent
5. Surgical procedures: more than 847,000 year-to-date
6. Number of ASCs: 261

"Our organization remains committed to our Patient First initiative, which was launched earlier this year and builds on the leadership position we have established to move the overwhelming majority of our services to in-network status and by supporting the critical safety net services delivered to patients by our facility-based providers and health system partners across the country," said Envision CEO Christopher Holden.

HCA Healthcare
7. Same-facility outpatient surgeries: 2.6 percent increase
8. Freestanding ASC same-facility surgeries: 1.5 percent increase
9. Sites of care: 1,800 (including ASCs, freestanding emergency rooms, urgent care centers and physician clinics)

HCA President and COO Samuel Hazen said during the call that acquisitions are still a part of the company's network development. "We've added some outpatient facilities here and there, some physician clinics, one of which that was sizeable in Austin, Texas, that supported our network there. So we continue to do these tuck-ins. We have, over the last year, added a few hospitals, and we'll continue to look for those as they surface. And as long as they make sense strategically and financially, we will pursue them with the same kind of disciplined approach we had in the past."

Mr. Hazen said the company was pleased with outpatient surgical growth in the quarter, due in part to physician recruitment and ASC development. "I don't feel compelled to have to do a large acquisition which could result in us acquiring ASCs, that's not in our core market. So very pleased with our strategy today and don't see a need to have to deviate from it," HCA CEO R. Milton Johnson said.

Surgical Care Affiliates, an Optum company
*Optum is part of UnitedHealth Group 
10. Optum Health revenue: $6.7 billion (16 percent growth)
11. People served: 92 million
12. Surgical facilities: more than 210

"One of the reasons why we invested in SCA [is] we viewed [it] as the right ambulatory surgical platform properly positioned in the higher acuity surgeries that were offered in those settings, and to have great ambition for its ability to expand ... Just as a reminder, SCA operates in 91 NPS zone. So, very progressive and doing so while saving consumers about 50 percent," said UnitedHealth Group CEO David Wichmann.

Surgery Partners
13. Revenue: $444.8 million (54.2 percent increase)
14. Same-facility revenue: 3 percent increase
15. Revenue per case: 4.5 percent increase
16. Same-facility cases: 1.4 percent decrease
17. Locations: more than 180

"[We may engage in] what I would call is a very innovative kind of outside-the-box new partnering, and that's where we explore opportunities with payers to actually co-invest in some of these ASCs and the opportunities we see there, to not only participate in the value chain of ASCs but be actually incented to really take advantage of the quality metrics that we have in these facilities in a low-cost environment, actually move more of their membership to an in-network but high-volume concentration, and I would tell you we have a couple of those discussions underway right now. I don't want to get over our skis on those, because large carriers can move sometimes slow in this process, but that being said, I'm hopeful we'll have at least one of those inked by the end of the year, which will be a real proof point as we move out with large carriers around the art of the possible," said Surgery Partners Director and CEO Wayne DeVeydt.

USPI, a Tenet company
18. Operating revenue: $531 million (12.5 percent increase)
19. Same-facility revenue: 6.9 percent increase
20. Same-facility cases: 4.3 percent increase
21. Same-facility revenue per case: 2.4 percent increase
22. Number of short-stay: more than 285

"We completed some great acquisitions [in 2018]," said Dallas-based Tenet Healthcare CEO and Executive Chairman Ronald Rittenmeyer. "Year-to-date, USPI has deployed $120 million on acquisitions. And importantly, our pipeline for both acquisitions and de novo development remains very strong, and we think it's likely we will exceed the $100 million to $150 million target for acquisitions and de novos this year. And frankly, we're happy to do it given the great returns in this business."


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