Physician ownership in ASCs is evolving, as increased consolidation efforts and other market pressures force physicians to adapt with new, hybrid models of facility ownership and governance.
Sarah Malaniak, administrator of Peakpoint Flatiron Surgery Center in New York City, recently joined Becker’s to discuss her predictions for how physician ownership in ASCs will change over the next five years.
Editor’s note: This response has been lightly edited for clarity and length:
Question: How do you see physician ownership in the ASC space changing over the next five years?
Sarah Malaniak. Administrator of Peakpoint Flatiron Surgery Center (New York City): Physician ownership in the ASC space is shifting toward more collaborative and diversified models. Traditional fully physician owned centers are becoming less common due to rising costs and administrative burdens. Instead, joint ventures with hospitals, private equity firms and management service organizations are gaining traction, allowing physicians to retain partial ownership while accessing capital and operational support.
Private equity continues to expand its footprint, consolidating ASCs into larger platforms. While this can improve efficiency and payer negotiations, it also raises concerns about reduced autonomy and profit-driven care. Health systems and insurers are also acquiring ASCs, creating vertically integrated models that may streamline operations but further limit physician control.
To maintain engagement and attract younger physicians, many organizations are offering flexible ownership structures, such as tiered equity models. Despite consolidation trends, there’s a growing movement among physicians to preserve independence through coalitions and innovative governance.
Over the next five years, I expect to see continued growth in joint ventures, strategic partnerships and a return to physician-led specialty ASCs, especially in areas like orthopedics and cardiology.
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.