USPI, HCA, Surgery Partners: Which fared the best in 2020?

The temporary halt on elective procedures during the pandemic last year caused revenue declines for three of the largest ASC chains in the U.S., but two still managed to grow through acquisitions and new ASC development.

Here are five points from each company's 2020 financial report.

United Surgical Partners International

1. Dallas-based USPI had interest in 308 ASCs, 40 urgent care centers, 24 imaging centers and 24 surgical hospitals at the end of 2020. The company plans to sell all its urgent care centers in early 2021.

2. Full-year net operating revenue hit $2 billion in 2020 compared to $2.1 billion in 2019. USPI's fourth quarter revenue increased from $632 million in 2019 to $649 million in 2020. Its acquisition of 45 ASCs from Towson, Md.-based SurgCenter Development drove the fourth quarter growth.

3. Same-facility surgical cases dropped 5.5 percent year over year in the fourth quarter and 15.2 percent in 2020 compared to 2019. Same-facility systemwide total ambulatory cases dropped 1.7 percent in the fourth quarter and 10 percent for the full year.

4. Same-facility systemwide net patient service revenue was $4.4 billion in 2020, down from $4.6 billion in 2019. The company was able to maintain revenue despite case volume drop during the pandemic by adding new service lines and incorporating more high acuity cases in their ASCs.

5. USPI expects net operating revenue to hit $2.8 billion to $2.9 billion in 2021. It projects net revenue per surgical case to drop 1 percent to 3 percent in the coming year. Surgical case volumes are expected to hit 98 percent to 103 percent of 2019 volumes in the coming year.

Click here for the full report.

HCA Healthcare

1. Nashville, Tenn.-based HCA reported 121 freestanding outpatient surgery centers in its network as of Dec. 31, 2020, down from 123 at the end of 2019.

2. The company reported 21 freestanding endoscopy centers at the end of last year, up from 20 endoscopy centers at the end of 2019.

3. The number of outpatient surgery cases dropped 12.6 percent in 2020, from 1 million in 2019 to 882,483 last year.

4. In the fourth quarter of 2020, outpatient surgery cases were 5.1 percent lower than the fourth quarter of 2019.

5. Outpatient revenue as a percentage of all patient revenue was 35.1 percent in 2020, down from 38.7 percent in 2019.

Click here for the full report.

Surgery Partners

1. Brentwood, Tenn.-based Surgery Partners reported 116 ASCs and 17 short-stay surgical hospitals in its portfolio to end 2020. More than 4,000 Surgery Partners-affiliated physicians treat 600,000-plus patients per year at the company's centers.

2. Surgery Partners reported full-year revenue for 2020 of $1.86 billion on Jan. 11. More than 50 percent of the company's net revenue comes from musculoskeletal procedures.

3. Case mix at Surgery Partners' ASCs is 38 percent orthopedics, 25 percent ophthalmology, 19 percent gastroenterology and 18 percent other procedures such as ENT and general surgery.

4. In 2020, Surgery Partners added robotic technology to 11 ASCs and now has 30 centers with robots.

5. Surgery Partners made 10 acquisitions in 2020 for about $160 million. In 2021, Surgery Partners plans to deploy more than $100 million in capital.

Click here for the full report.


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