USPI vs. Surgery Partners vs. HCA Healthcare: 12 financial notes 

Here are 12 financial notes from three of the biggest ASC operators, pulled from their most recent financial reports:

United Surgical Partners International (Dallas)

1. USPI reported $4.5 billion in net operating revenues for 2024, a 15.4% increase from $3.9 billion in 2023. 

2. USPI’s net operating revenues for the fourth quarter of 2024 reached $1.3 billion, a 16.9% increase from $1.1 billion in Q4 2023.

3. The company’s adjusted EBITDA for Q4 2024 was $530 million, a 14.2% increase from $464 million in Q4 2023.

4. Full-year EBITDA climbed 20% to $1.8 billion, up from $1.5 billion in 2023, reflecting strong revenue per case growth, disciplined expense management and acquisition contributions.

HCA Healthcare (Nashville, Tenn.) 

1. As of Dec. 31, HCA operated 190 hospitals and 2,400 ambulatory care sites, including ASCs, freestanding emergency rooms, urgent care centers and physician clinics, across 20 states and the United Kingdom.

2. Same-facility outpatient surgeries decreased by 2.4% in Q4 2024 compared to the same period in 2023. For the full year 2024, the decline was 1.9% compared to 2023. 

3. Outpatient revenue accounted for 37.9% of total patient revenue in Q4 2024, a slight decline from 38.4% in Q4 2023.

4. HCA reported a net income of $5.8 billion in 2024, representing a 9.9% increase from $5.2 billion in 2023.

Surgery Partners (Brentwood, Tenn.)

1. Surgery Partners’ revenue increased 17.5% in the fourth quarter, reaching $864.4 million, up from $735.4 million in the same period of 2023. Full-year revenue grew 13.5%, reaching $3.1 billion, compared to $2.7 billion in 2023.

2. Same-facility revenues rose 5.6% in Q4 and 8% for the full year, while same-facility cases increased 5.1% in Q4 and 3.9% for the full year.

3. Surgery Partners reported a $108.5 million net loss in Q4 and a $168.1 million net loss for the full year.

4. Adjusted EBITDA climbed 15.1% in Q4 to $163.8 million. For the full year, adjusted EBITDA rose 16% to $508.2 million.

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