The 2025 moves of the big 5 ASC operators

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The nation’s five largest ASC companies — United Surgical Partners International, AmSurg, Surgery Partners, HCA Surgery Ventures and SCA Health — have made major moves in 2025, from billion-dollar revenue gains and guidance raises to acquisitions and consolidation. 

Together, their strategies highlight the continued shift toward higher-acuity outpatient care and the growing scale of the ASC market.

USPI (Dallas)

  • USPI added eight  ASCs in the second quarter of 2025 and raised 2025 guidance after a strong second quarter; Tenet now projects USPI adjusted earnings before interest, taxes, debt and amortization of $1.99 billion to $2.05 billion.
  • First-quarter 2025 revenue hit $1.2 billion, up from $995 million year over year, as USPI continued shifting toward higher-acuity cases.
  • USPI is sharpening its focus on orthopedic-driven centers and moving away from lower-acuity, high-volume procedures. 

AmSurg (Nashville, Tenn.)

  • Ascension entered a definitive agreement to acquire AmSurg, vaulting the health system into a top-tier ASC competitor. 
  • Earlier in 2025, AmSurg continued tuck-in acquisitions, including a majority stake in Texarkana (Texas) Surgery Center, as part of a broader growth push. 

Surgery Partners (Nashville)

  • Q2 2025 revenue reached $826.6 million (up 8.4% year over year); same-facility revenue rose 5.1% and cases 3.4%; adjusted EBITDA climbed 9% to $129 million; fiscal 2025 guidance was reaffirmed. 
  • Surgery Partners also rejected a buyout proposal from Bain Capital, signaling confidence in its independent growth strategy.

HCA Surgery Ventures (Dallas)

  • Freestanding ASC count rose to 124 in Q2 2025; outpatient services accounted for 38.4% of total patient revenue as HCA’s ambulatory mix continued to grow. 
  • Same-facility outpatient surgeries dipped 0.6% (inpatient  fell 0.3%) in Q2, while HCA raised full-year 2025 revenue outlook to $74 billion and $76 billion.

SCA Health (Deerfield, Ill.)

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.

Register to Attend Webinar

Is ambulatory care healthcare’s big margin engine? 4 leaders weigh in

Wednesday, July 29
1:00 PM - 2:00 PM CDT

Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

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