Here are 10 trends within the ASC industry shaping the way that leaders and physicians approach ASC finances in 2025:
1. Physicians still hold majority stakes in most ASCs, according to a March 13 MedPAC report to Congress. Most ASCs are at least partially owned by physicians, maintaining a long-standing trend of clinician investment in outpatient surgical care.
2. However, corporate ownership is rising. Between 2018 and 2023, the number of ASCs owned by one of the five largest corporate entities — United Surgical Partners International, AmSurg, Surgical Care Affiliates, HCA Healthcare and Surgery Partners — rose by 15.7%, growing from 1,152 to 1,333 facilities, according to the MedPAC report.
3. Overall corporate presence is growing slowly. During the same five-year span, the overall share of ASCs with some level of corporate ownership grew modestly, from 20% to 21.1%.
4. Hospitals and health systems are increasingly interested in investing in ambulatory care. A January 2024 survey of health system executives by VMG Health found that 60% of leaders were considering pursuing outpatient surgery joint ventures in 2024, the highest area of interest of any potential specialty partnerships.
5. A majority of ASCs specialize in a single specialty, with gastroenterology leading the way, according to the MedPAC report.
6. An emerging growth opportunity for ASCs may lie in partnerships with other outpatient facilities, such as urgent care clinics and orthopedic walk-in centers, according to Alejandro Badia, MD, founder and chief medical officer of Miami-based Badia Hand to Shoulder Center.
“Once a patient is seen in a hospital emergency room, for example, that patient will likely undergo surgery at that facility, often whether urgent or not,” he told Becker’s. “Collaboration between a convenient walk-in facility, for example, an orthopedic urgent care center and as ASC, will drive up musculoskeletal surgical volume, while lowering overall healthcare system costs.”
7. Beckers has reported on several ASC and physician practice management organizations that are utilizing new business models to center physician independence while supporting future ASC growth. These organizations do not typically acquire an ASC or physician practice outright, rather they invest in them to provide strategic operational and financial support.
8. Shakeel Ahmed, MD, CEO of Atlas Surgical Group in St. Louis, spoke to Becker’s about the regulatory issues holding back ASC growth in 2025.
“Certificate-of-need laws, Stark law restrictions and site-neutral payment disparities remain the biggest barriers we face,” he said. “Certificate-of-need laws are outdated relics that still exist in several states, requiring surgery centers to prove public need before opening — a monumental task that local hospitals successfully block in most cases.”
9. ASCs also continue to battle decline to physician reimbursements. The House of Representatives has introduced a new funding bill to keep the government running through Sept. 30, but notably missing is a fix to the 2.83% cut to Medicare physician reimbursement.
10. After several years of “lackluster” deal activity, bankers and private equity advisors recently told The Wall Street Journal that physician practice deals are showing more promise, possibly making space for more PE firms to exit their holdings. Private equity is also reportedly sitting on $75 billion in uninvested capital in the healthcare industry and has owned more than 200 healthcare provider businesses in the U.S. and Canada for at least five years, Rebecca Springer, director of market development at investment bank Bailey & Co. told the Journal.
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