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 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.
- 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.
- 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.
- 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.
- Optum-owned SCA Health acquired U.S. Digestive Health Management, adding 24 ASCs and more than 40 GI practice sites in Pennsylvania and Delaware to its platform.
- The company also closed Perimeter Surgery Center in Atlanta, consolidating services into a nearby outpatient site as part of its ongoing footprint realignment.
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
