Tenet’s ASC arm, United Surgical Partners International, is positioning itself for a new growth runway as Medicare begins phasing out its inpatient-only list in 2026, a policy shift the company said will gradually expand the number of higher-acuity procedures moving into lower-cost sites of care.
During Tenet’s fourth-quarter and full-year 2025 earnings call, CEO Saum Sutaria, MD, described the IPO phaseout as something that will accelerate the ASC migration that USPI has already been capitalizing on.
“The continued shift of services toward lower-cost sites of care will be furthered by the beginning of the phaseout of the inpatient only list in 2026,” Dr. Sutaria said. “We see this as a gradual tailwind for USPI that will play out over several years.”
In the first year, he said USPI expects to benefit most in areas such as high-acuity spine and urology procedures, adding that USPI has “detailed tactical plans” and is “actively operationalizing” its capabilities for 2026.
USPI enters that transition with strong financial momentum. In 2025, USPI adjusted EBITDA grew 12% to $2 billion, while same-facility revenues rose 7.5%.
Dr. Sutaria also highlighted “double-digit” same-store volume growth in total joint replacements at USPI’s ASCs, which exceeded the company’s long-term goal of 3% to 6% organic top-line growth.
Tenet is also expanding USPI’s footprint to capture more volume as site-of-care migration continues. The company invested nearly $350 million in USPI M&A and de novo activity in 2025, adding 35 facilities to the portfolio. For 2026, USPI is targeting $250 million annually for M&A.
“The pipeline for both M&A and de novo development remains strong,” CFO Sun Park said. “We remain the preferred acquirer and developer of assets in this space.”
Dr. Sutaria said USPI is also leaning on clinical and technology platforms that support higher-acuity outpatient growth. Notably, USPI is continuing to expand its urology platform and that expanding robotics capabilities in ASCs is opening “new avenues of expansion.”
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