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HIDA 2018 Ambulatory Surgery Center Market Report

HIDA 2018 Ambulatory Surgery Center Market Report

Market At-A-Glance
The ambulatory surgery center (ASC) market was estimated to reach $36 billion in 2018, and is projected to increase to $40 billion by 2020. Drivers for revenue growth are: lower outpatient surgery costs in ASCs compared to other settings, improved safety driven by technological advancements, and the aging U.S. population.

There are more than 6,100 ASCs in the U.S, and as of 2016, 5,519 were Medicare-certified. Approximately 70% of ASCs are owned by independent physician groups. The top five industry leaders own less than 20% of ASC market share.

Shift To Outpatient Continues
As of 2017, more than half of outpatient surgeries were performed in an ASC setting, up from 32% in 2005.
Based solely on population growth forecasts, outpatient procedure volumes are predicted to increase 14% from 2016 to 2026. However, analysts predict this number will be higher (16%) due to the growing shift in surgical procedures from inpatient to outpatient settings.

Each year, the Centers for Medicare and Medicaid Services (CMS) evaluates a list of approximately 1,700 procedures that are designated as inpatient-only. With improvement in medical technologies, an increasing number of procedures are being removed from this list, allowing them to be performed in outpatient settings. In 2018, six procedures were removed from this list.

ASCs Cut Costs For Payers, Patients
Commercial payers were 64% of the ASC payer mix in 2017, followed by Medicare at 19%. In an effort to reduce costs and increase value, payers are driving the shift in procedures from high-cost settings to more cost-effective ASCs. For example, joint replacement in a hospital outpatient department (HOPD) costs an average of $40,000 versus $18,000 in an ASC. The same is true for cataract surgery with an average cost of $1,745 in an HOPD and $976 in an ASC.

Patients also benefit from these savings. As ASC volumes increase in coming years, total out-of-pocket expenses for procedures could fall by as much as $5.0 billion.


Executive Summary
Table of Contents
Ambulatory Surgery Center Market Overview
Outpatient Volumes Projected To Increase 16% By 2026
Growth In Outpatient Procedures To Drive Additional ASC Volume
Removal Of Surgeries From Inpatient-Only List Increases Procedures Available To ASCs
Most Operating Costs Spent On Supplies And Salaries
Orthopedic Procedures Most Costly
Commercial Insurance Continues To Make Up More Than Half Of ASC Payer Mix
ASC Nurses Earn Higher Wages
Gastroenterology, Ophthalmology Major ASC Specialties
Orthopedics, Otolaryngology, Podiatry, Generate Highest Revenues
Cataract Procedure Remains The Most Commonly Performed Surgery In ASCs
ASCs Specializing In Cardiology Most Likely To Require Post-Surgery Hospitalization
Patients Save Money Through ASC Utilization
Price Transparency Beneficial To ASCs
ASCs Gain At The Expense Of Hospitals
In 2018, ASC Quality Reporting Program Adds Two Measures, Discontinues Three
Number Of ASCs Higher For States Without CON Requirement
Healthcare Execs To Pursue ASCs For M&A, Most ASCs Expect No Activity
ASC Management Companies Expand Investment In 2018
Health System Affiliation Not On The Horizon For Most ASCs
One-Third Of ASCs Plan To Expand In 2019
HOPD To ASC Conversion Potentially Beneficial To Hospitals

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