Nonprofit ambulatory surgery centers made up just 20% of Pennsylvania’s ASC market in 2024, yet they pulled in more than half of the market’s total net income, according to research published Sept. 25 in JAMA Health Forum.
The study analyzed 2024 financial and operational data for 257 Pennsylvania ASCs reporting complete information, including 204 for-profit and 53 nonprofit facilities. The data was pulled from the Pennsylvania Health Care Cost Containment Council and the Pennsylvania Department of Health.
Here are eight things to know about the financial gap between nonprofit and for-profit ASCs:
- Nonprofit ASCs’ median profit margin was 37.8%, more than double the for-profit median of 16.4%.
- More than 26% of nonprofit ASCs reported margins above 51%, and 24% of for-profit ASCs reported margins above 29%.
- Nonprofit ASCs generated far more per patient visit, with median net income per visit of $592 for nonprofit ASCs versus $197 for for-profit ASCs.
- Nonprofit ASCs had a median of 4,598 visits compared with 3,613 visits at for-profit ASCs, and median net patient revenue was $8.48 million versus $4.74 million.
- Nearly all nonprofit ASCs in the study (94.3%) were affiliated with a health system, compared with just 27.0% of for-profit ASCs. The top nonprofit system owners were UPMC (11 ASCs), Penn Medicine (6), Geisinger (5), Highmark Health (5) and Jefferson Health (5). Among for-profits, SCA Health (7), Tenet Health (5) and UPMC (5) were the top owners.
- Nonprofit ASCs were more likely to be multispecialty, as 62.3% offered multiple specialties, compared with 29.9% of for-profit ASCs. Nonprofits’ most commonly reported specialty was gastroenterology (73.6%), followed by orthopedics (58.5%) and ophthalmology (50.9%). For-profits’ most common specialties were ophthalmology (37.7%), gastroenterology (33.8%), and dermatology and pain management (32.4% each).
- For-profit ASCs relied more heavily on Medicare, which made up a median 31.9% of revenue versus 23.6% at nonprofit ASCs. Nonprofit ASCs drew a higher share of Medicaid revenue (3.4% versus 1.6%).
- The study ties the findings to broader shifts already reshaping the ASC sector, including CMS phasing out the Inpatient-Only list, expanding the list of procedures covered in ASCs, introducing site-neutral payments and state-level Certificate of Need reform. These factors suggest continued ASC growth as health systems and cost-conscious employers push more procedures out of hospitals.
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.
