Survey: Most hospitals, health systems are increasing investment in ASCs

Editor's Note

In this annual survey published by Avanza Healthcare Strategies and titled “2021–2022 Hospital Leadership ASC Survey,” senior healthcare executives and clinical leaders shared insights into hospital-owned and hospital-physician joint venture ambulatory surgery center (ASC) trends. The responses show that “hospitals and health systems of all sizes are expanding their ASC portfolios,” and more than 60% are planning to grow their investments.

The survey cited various factors as contributing to the increase in ASC investments, including:

• ongoing shift of surgical procedures into the outpatient setting
• growing competition over physicians and cases
• better incentives and long-term payoffs for physician owners
• value-based care movement.

According to the survey, most hospital systems already own an ASC, with 61% owning two or more, and 32% owning five or more centers. In addition, 82% “of hospitals and health systems surveyed have one or more of their ASCs as joint ventures with physicians.”

Between 2020 and 2021, “the percentage of ASCs with 100% hospital and health system ownership declined while hospital and health system majority ownership in ASCs increased,” the survey noted. Along the same veins, outsourcing management of ASCs dropped from 23% in 2019 to 15% in this survey, and hospitals and health systems with ASCs that allow third-party equity partners dropped from 44% in 2018 to 27% in this survey.