The growing role of ASC-health system partnerships in outpatient care and what to watch out for

I have long been a strong proponent of Ambulatory Surgery Centers (ASCs). Having spent over 20 years in the ASC management space, I witnessed first-hand how these facilities transformed healthcare delivery. In the early years, we championed the cost savings ASCs offered to patients, insurers, and Medicare—all while maintaining hospital-level quality and safety. Importantly, ASCs led the way in transparency by self-reporting outcomes and self-policing standards, ensuring patient safety remained paramount.

In many ways, ASCs were the earliest and truest examples of value-based care. A 2022 Medicare report found that ASC procedures cost, on average, 35% less than comparable hospital outpatient procedures, with similar safety outcomes. From my own experience, that savings are often closer to 50%.

Having also worked within health systems and hospitals, I applaud their growing recognition of the need for a robust outpatient strategy. Care should be delivered in the most convenient and cost-effective setting for patients—always guided by the advice of their physician. It is no surprise that headlines today are filled with news of hospitals and health systems forming partnerships with outpatient providers.

Among the most notable trends are collaborations between health systems and ASC management companies, sometimes described as the “Tenet/USPI model.” The recent Ascension acquisition of AmSurg is a prime example. While these represent larger-scale deals, there are countless smaller partnerships emerging as health systems choose ASC management companies to help execute their outpatient strategies.

The value proposition is clear: when health systems partner with ASCs, they can expand patient access, improve convenience, and increase capacity by shifting lower-acuity procedures to ASCs while reserving hospital space for higher-need patients. This not only supports patient-centered care but also contributes to slowing healthcare cost growth.

Yet, there is a side of these partnerships that rarely makes the headlines—the upside for existing ASCs. Much of the discussion focuses on how hospitals sacrifice revenue by moving cases out of hospital outpatient departments. But what is less discussed is how these deals benefit ASCs and their management partners.

Other than the additional volume, the key driver is commercial insurance rates. When a health system acquires a majority stake in an ASC, it brings negotiating power to the table. Leveraging the system’s broader network and payer relationships, these ASCs often secure higher commercial reimbursement rates. For ASC operators and management companies, this translates into significant revenue growth and a stronger long-term position in the market.

Ultimately, the success of these partnerships will depend on staying true to the value-based care principles ASCs pioneered: delivering high-quality, safe, and cost-effective care in the most appropriate setting for patients. When both sides—the health system and the ASC—align on that mission, everyone benefits; patients, providers, payers, and the healthcare system as a whole.