The ASC space is ripe for facility-level consolidation, according to VMG Health.
Six key market insights:
1. The ASC market didn't see any platform-level transactions in 2019, but consolidation continued in the fractured sector.
2. About 71 percent of ASCs remain independent, leaving room for further facility-level consolidation.
3. The ASC market remains an active transaction arena, with major operators seeking new ASC opportunities.
4. As of Dec. 31, 2019, the three largest ASC operators (by number of ASCs) were:
- Addison, Texas-based United Surgical Partners International: 264
- Nashville, Tenn.-based Envision Healthcare/AmSurg: 258
- Deerfield, Ill.-based Surgical Care Affiliates: 186
5. The number of total Medicare-certified ASCs partnered with a national operator increased from 5,700 centers in 2018 to 5,788 in 2019.
6. The five largest ASC management companies have increased the number of centers under management by about 359 since 2011, for a compound annual growth rate of 4.1 percent.
"We are continuing to see themes from 2018 play out in 2019 and into 2020," VMG Health analysts concluded. "The expectation is that there would be further consolidation within the ASC market with a greater involvement by private equity companies. At the center level, higher acuity case volume will continue to shift from the inpatient setting further cementing the ASC as the low-cost, efficient alternative to the hospital setting."