As the healthcare landscape continues to shift toward outpatient, health systems are rapidly expanding their ASC strategies.
Here are five organizations are leading the way in reshaping what the ASC of the future looks like:
Sutter Health
Sacramento, Calif.-based Sutter Health is doubling down on ambulatory care. Bradley Heaton, CEO of the health system’s surgery center division, emphasized Sutter’s long-term commitment to ASC expansion in an interview with Becker’s .
“The ASCs within our system are a critical part of that work and what we’re trying to accomplish as a health system,” Mr. Heaton said. “[E]ven within Sutter Health, we are continuing to expand our footprint with more ASCs and have comprehensive plans to increase access in the coming years. Our goal is to provide more care for patients seeking high-quality, efficient and affordable healthcare.”
Sutter currently operates 36 ASCs, a number Mr. Heaton expects to grow significantly. The health system is converting a 60,000-square-foot office building into an ASC and specialty clinic, and plans are underway to build a flagship campus in Emeryville, Calif., that will include an ambulatory care complex and a 200-bed medical center.
According to Mark Sevco, senior vice president and COO, Sutter has over $1 billion in ambulatory projects underway, with 27 developments across Northern California, he told Becker’s. Nineteen of those are slated to open in 2025.
AdventHealth Florida:
In East Florida, one of the fastest-growing regions in the country, AdventHealth is investing in ASCs as an essential piece of its care delivery model. Rather than positioning ASCs in competition with hospitals, the system is strategically integrating them as complementary entities.
AdventHealth is developing ASCs as standalone businesses with unique operational, financial and partnership models. This flexibility, while still aligned with the broader system goals, is driving growth.
“We all grow together,” Shyroll Morris, senior vice president and chief strategy officer of Altamonte Springs, Fla.-based AdventHealth’s East Florida division, told Becker’s. “That’s been key, and now everyone sees the value of having these additional service locations in the market. It helps consumers, and it helps us grow overall market share.”
One standout feature of AdventHealth’s model is strong physician engagement. The system recently entered a joint venture with Cardiology Physicians and North Florida Surgeons to build a medical office and ASC. The first syndication round drew 15 physician investors, with a waitlist already forming for the next. The strategy hinges on shared ownership and decision-making, which has fostered loyalty and alignment between AdventHealth and its physician partners.
Trinity Health
Livonia, Mich.-based Trinity Health is choosing organic ASC development over acquisition. The 93-hospital system is investing heavily in outpatient care, including ASCs, urgent care, imaging, and infusion centers.
“One of the most significant trends is the shift of care and resources into the ambulatory setting. While this shift has been going on for a long time, what’s notable now is the substantial allocation of capital and assets in this space,” said Daniel Isacksen Jr., Trinity’s executive vice president and CFO, on the Becker’s CFO and Revenue Cycle Podcast.“We’re seeing major investments in comprehensive ambulatory centers, medical group facilities, ambulatory surgery centers, retail imaging and infusion centers. These changes are significantly influencing capital investment strategies and will continue to do so.”
While Trinity has previously partnered with outside ASC operators, it is now focusing on building and managing these services in-house. The system is recruiting specialized talent and developing internal programs to better serve its communities directly.
Tenet Healthcare
Dallas-based Tenet Healthcare is aggressively expanding its outpatient footprint following a series of hospital divestitures in 2024. While the sales have helped reduce the company’s debt, a significant portion of the proceeds is being reinvested into ambulatory growth — particularly through strategic acquisitions and de novo ASC developments.
As the parent company of United Surgical Partners International, the largest ASC chain in the U.S., Tenet plans to invest at least $250 million annually in ambulatory mergers and acquisitions.
“The pipeline looks good,” CEO Saum Sutaria, MD, said during an earnings call, noting that although $250 million is the company’s baseline goal for M&A, Tenet has averaged nearly twice that amount in annual spending over the past five years.
Beyond acquisitions, Tenet is also bullish on organic ASC development. Dr. Sutaria noted that USPI has a robust pipeline of new centers in development, many structured as physician syndications. These new ASCs are being designed with a focus on service-line diversification, particularly in high-growth specialties like orthopedics.
Dr. Sutaria also pointed to three key drivers of revenue-per-case growth at USPI: its robust contracting platform, an emphasis on higher-acuity procedures, and strategic shifts in case volume. During Tenet’s third-quarter 2024 earnings call, he noted that USPI is actively identifying opportunities to “migrate certain lower-acuity, higher-volume types of activities out of the ASCs” to free up capacity for more complex, higher-margin cases.
Bon Secours
Cincinnati-based Bon Secours Mercy Health, a 48-hospital Catholic system, has teamed up with Compass Surgical Partners to develop more than 30 ASCs across multiple states.
“We look forward to expanding access to care through a robust ASC strategy,” David Cannady, chief strategy officer of Bon Secours Mercy Health, told Becker’s. “We are focused on ensuring we have proper pacing and prioritization of projects that allow us to scale efficiently. We are also committed to developing solid physician partnerships and securing managed care contracts. Compass brings significant experience and expertise in each of these areas, and we are already seeing the value of our partnership in accelerating our ambulatory footprint.
In addition to the partnership, Bon Secours is adding internal expertise to work with both hospital operators and Compass, Dr. Cannady said.
“These teammates will help to identify service lines and procedures for which the migration to ambulatory makes clinical, operational and financial sense,” he said. “We will also work with our population health and case management teams to assist patients through the care continuum following their ASC experience.”
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