During the health system’s Jan. 24 earnings call, Mr. Hazen said he was “against program implementations that would cut Medicare hospital outpatient reimbursement,” emphasizing operation and resource disparities between hospitals and ASCs.
For service lines like surgery, hospitals provide 24/7 services with comprehensive resources, including physicians, staff and equipment, he continued. In contrast, ASCs generally operate during regular business hours.
“The idea of paying the same rate for those does not seem to make a lot of sense to us,” he said.
Mr. Hazen also noted the absence of finalized legislation detailing site-neutral payment policies, which limits the ability to estimate any financial impact. Despite this uncertainty, he affirmed that such policies are unlikely to disrupt HCA’s ASC development plans.
“We don’t see that any site-neutral policy per se will force us or cause us to rethink our strategy around building out our outpatient networks,” he said. “We believe we are finding opportunities to extend the reach of our networks into new communities again, make it more convenient and more efficient for the patient, and then fully integrate that particular facility into the larger hospital centric health system as part and parcel to our network development strategy.”
HCA Healthcare is one of the largest ASC operators in the United States, managed under its Surgery Ventures division. By the end of 2024, the organization operated 124 ASCs and approximately 14 outpatient facilities per hospital, according to CFO Mike Marks.
“We feel good about our ambulatory surgery center network,” Mr. Marks said. “They’re an important part of our overall network and the markets we serve, and it will continue to be a part of network development and optimization strategy in ’25 and beyond.”
In a third-quarter earnings call, Mr. Hazen said that HCA Healthcare’s ASC strategy is driven by “greenfield developments,” new facility construction and targeted acquisitions.