ASCs are slowly consolidating. Here's what that looks like.

As of 2022, 70 percent of ASCs were independent, but the industry is slowly consolidating.

From 2021 to 2022, the number of ASCs under partnership by a national operator increased from 1,752 to 1,804.

With the big five — United Surgical Partners International, AmSurg, SCA Health, HCA Healthcare and Surgery Partners — seeing an increase of about 511 centers since 2011, it is clear the industry is steadily consolidating.

Outside factors such as declining reimbursement and increased operating costs could accelerate this trend. 

"If the current trend of declining reimbursement and rising overhead/salary costs will continue, there will be greater consolidation of ASCs into large organizations (such as United Surgical Partners International)," Vladimir Sinkov, MD, a spine surgeon at Southern Hills Hospital in Las Vegas as well as founder and CEO of Sinkov Spine Center in that city, told Becker's. "Hospitals will also continue partnering with ASCs to offset surgical case 'leakage' to outpatient settings. The end result will be greater consolidation and fewer independent ASCs."

However, one ASC leader said increased consolidation is not necessarily in the cards. 

"I don't see a significant uptick in ASC acquisition this year, though we may continue to see consolidation among management companies," Alfonso del Granado, administrator and CEO of Lubbock, Texas-based Covenant High Plains Surgery Centers, told Becker's. "I cannot speak to the acquisition side, but from the ASC management perspective I see significant growing pains in setting up management and communication systems, integrating the hodgepodge of an ASC's existing software applications with the management company, for example."

"The result is labor-intensive manual reporting at some of the largest management companies, which takes away time that administrators need to focus on service quality and growth and increases bureaucratic workload upstream," Mr. Granado said. "It would not surprise me if this is one of the factors contributing to the slowdown in consolidation." 

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