4 3
A U G U S T 2 0 1 5 | O U T P A T I E N TS U R G E R Y. N E T
Ambulatory surgery centers appear to
be opening and closing at about the
same rate, with roughly 100 being
built each year and roughly 100 clos-
ing, says Jon Vick, president of consult-
ing firm ASCs, Inc.
"The market is saturated, growth has
leveled off, and that's not expected to
change," says Mr. Vick.
As of 2014, there were 5,377 Medicare-certified ASCs. That's a huge jump from the 326 that
existed in 1986, but it's only a tiny increase from the 5,316 that existed in 2010.
Those closing down, says Mr. Vick, include some that are being converted to GI endoscopy
centers or cardiac catheterization labs, but many are also simply falling by the wayside, unable to
recruit new physicians or find buyers.
Then there's attrition on another front. An increasing number of hospitals are converting sur-
gery centers into hospital outpatient departments. Of the 205 surgery centers that closed
between 2009 and 2011, hospitals flipped more than one-third of them to HOPDs, says the
Ambulatory Surgery Center Association (ASCA). Between 2009 and 2014, ASCA estimates that
there have been more than 110 ASC-to-HOPD conversions.
Meanwhile, hospitals have become a major player, and now have ownership stakes in an esti-
mated 24% of ASCs, up from about 2% in 2000. According to this current ownership breakdown,
based on estimates provided by ASCs, Inc., physician-owned ASCs still dominate the market-
place:
• Physicians only: 62% • Corporation/hospital/physician(s): 6%
• Hospital/physician(s): 16% • Corporation only: 6%
• Corporation/physician(s): 8% • Hospital only: 2%
— Jim Burger
PLUSES AND MINUSES
ASCs Now Rising andFalling at the Same Rate
