Several ASC chains have dominated the market over the last 10 years, acquiring independent and physician-owned centers nationwide.
Here is how five of the largest chains, by number of centers, have positioned themselves for 2025:
United Surgical Partners International, owned by Tenet Healthcare (Dallas)
USPI is turning its focus to AI for 2025. At the end of 2024, its parent company, Tenet, launched Commure’s ambient AI platform across its physician network. Tenet Physician Resources will have access to Commure’s AI platform, which looks to minimize administrative burdens and integrate workflows by streamlining data collection, documentation and care delivery.
Tenet is also focusing more on outpatient than inpatient care for 2025. Last year, it sold 14 hospitals in 2024 for a total of $4.8 billion, according to an Oct. 29 third-quarter earnings call. The profits from these sales has led to greater investment in its outpatient care. “We continue to believe accelerating spend at USPI is the single most accretive thing to bring value within the company,” Tenet CEO Saum Sutaria, MD, said.
USPI and Tenet are also focusing on value-based care. Tenet is accelerating its portfolio transformation towards a more value-based care enterprise with a leading specialty care platform, the company said in a proxy statement filed April 12, 2024, with the Securities and Exchange Commission. Tenet’s investment strategy is changing as the continuing trend of care shifts away from hospitals toward outpatient and other, more convenient, care settings.
USPI is setting its sights on more high-acuity cases, like orthopedics and spine. In 2023, USPI reported joint replacement procedures at its surgery centers jumped 20% year over year in the fourth quarter, and were up 15% for the full year.
In its ambulatory segment, Tenet projects operating revenue between $4.9 billion and $5 billion for 2025.
SCA Health, owned by Optum (Deerfield, Ill.)
SCA Health is focused on both expansion and consolidation. Most recently, SCA Health’s Perimeter Surgery Center in Atlanta closed Dec. 20 and is moving its operations to Atlanta Outpatient Surgery Center.
SCA is also focused on expanding into more high-acuity cases. At the end of 2024, it announced plans to acquire OrthoAlliance, a musculoskeletal management services group.
AmSurg (Nashville, Tenn.)
AmSurg is expanding its partnership opportunities. AmSurg partnered with Owings Mills, Md.-based LifeBridge Health and Pikesville, Md.-based Woodholme Group to open a gastroenterology ASC in Westminster, Md.
The company also recently partnered with Escondido, Calif.-based Palomar Health.
2025 has been a major year of acquisitions for AmSurg, as it continues to grow its ASC footprint. In January, it acquired majority ownership interest in Texarkana (Texas) Surgery Center. In April it acquired Pinnacle Surgery Center in Covington, La.
The company also went through a rebrand in 2025, revamping its company values that will guide care at its partner ASCs, of which there are more than 250. The four new values are to care deeply, cultivate integrity, champion excellence and celebrate teamwork.
HCA Healthcare (Nashville, Tenn.)
HCA Healthcare is continuing to expand partnerships. Oakland, Calif.-based Kaiser Permanente and Denver-based HCA HealthOne, part of HCA, expanded their relationship to provide additional healthcare access in central Denver.
The company is continuing to invest capital into the cardiology sector, as it saw growth from both inpatient and outpatient cardiac surgeries during the first quarter of 2025.
Sam Hazen, the company’s CEO, said that HCA is unconcerned about the potential effects of site-neutral payment policies on its ASC development strategy during an earnings call in January.
In addition, HCA is also focusing on the use of new technologies. Laurel, Va.-based Virginia Care Partners, an affiliate of HCA Virginia in Richmond, established a partnership with Pearl Health, a technology platform geared specifically toward independent physician practices.
Surgery Partners (Brentwood, Tenn.)
Surgery Partners and Leakwood, Kan.-based ValueHealth completed a new ASC in The Villages, Fla., in October 2024. The ASC offers cardiology, urology, orthopedics, gynecology, gastroenterology, podiatry and other specialty services.
In addition, the company is facing pressure from private equity firm Bain Capital, who wishes to fully acquire the MSO. On Jan. 27, Surgery Partners received a nonbinding acquisition proposal from Bain, offering to buy all outstanding shares for $25.75 per share in cash. Bain already has a 39% stake in Surgery Partners and is not interested in selling the shares it owns.
Surgery Partners is focused on the continued growth of orthopedics in 2025. In January, Laura Forese, MD, was named to Surgery Partners’ board of directors. Orthopedics remains a key growth area for Surgery Partners with total joint replacements driving increases in volume, CEO J. Eric Evans said in a May 12 earnings call. Surgery Partners facilities saw more than 29,000 orthopedic cases in the first quarter of 2025, a 3.4% year-over-year increase, Mr. Evans said, according to a transcription by Reuters. Total joint replacements saw a 22% jump in growth year over year.
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