U.S. Ambulatory Surgical Centers Market Size, Share & COVID-19 Impact Analysis, By Type (Single-specialty, and Multi-specialty), By Ownership (Physician-owned, Hospital-owned, and Corporate-owned), By Application (Diagnostic Services and Surgical Services), and Country Forecast, 2023-2030

The U.S. ambulatory surgical centers market size was valued at USD 43.70 billion in 2022. The market is projected to grow from USD 46.62 billion in 2023 to USD 75.20 billion by 2030, exhibiting a CAGR of 7.1% during the forecast period.

Ambulatory Surgical Centers (ASCs) refer to innovative outpatient healthcare centers offering surgical services, such as preventive and diagnostic services on the same day. These settings offer a comfortable ambience and affordable services compared to most hospitals in the U.S. The specialty services offered by these settings include surgeries related to orthopedics, pain management, ophthalmology, gastroenterology, dermatology, and urology.

The market’s growth is mainly attributed to the increasing need for new solutions and innovations to cut down healthcare costs in the U.S. Moreover, the growing incidence of chronic diseases requiring surgeries is driving the market growth. Furthermore, rising investments, a shift in patients’ admission from hospitals to ambulatory surgical centers, and favorable reimbursement scenarios are propelling market progress. Additionally, the increasing number of these centers over the last decade will drive the market outlook.

• According to the Ambulatory Surgery Centers Association, the number of Medicare-certified ASCs in the U.S. was 6,087 in 2022 compared to 5,937 in 2019.

COVID-19 IMPACT

Decline in Surgeries During COVID-19 Pandemic Reduced Market Revenue

The COVID-19 pandemic had a negative influence on the market. Challenges, such as shortage of workforce, procedural prioritization, risk of transmission of COVID-19 virus, and the limited number of surgical procedures in these settings, challenged the market’s growth during this period. ASCs in the U.S. witnessed a decline in the number of visits, thereby reducing the overall revenue of ambulatory settings. Moreover, operational restrictions, such as mandates to stop or postpone elective surgeries during the COVID-19 pandemic, negatively impacted the market.

• For instance, in April 2020, the Centers for Medicare & Medicaid Services, in collaboration with medical societies and associations, announced recommendations for postponing non-essential surgeries and other procedures with the help of a tiered framework.

Additionally, factors including the rapid spread of the COVID-19 pandemic through public gatherings and conserving vital resources, such as personal protective equipment and mechanical ventilators, postponed the elective surgical procedures in these settings in 2020. However, the migration of patients from hospitals to ambulatory surgical centers is expected to be rapid post the COVID-19 outbreak. The resumption of elective procedures also increased the patient volume in 2021 and helped the market recover partially and reach to the pre-pandemic level. In the same year, the substantial increase in the revenue of ambulatory settings due to increased patient visits also contributed to the surge in the market’s growth. Furthermore, in 2022, the U.S. ambulatory surgical centers market was fully recovered and bounced back to its pre-pandemic level of growth.

U.S. Ambulatory Surgical Centers Market Trends

Strategic Mergers & Acquisitions to Determine Market’s Growth Trajectory

One of the most important trends witnessed in this market in the U.S. is that there has been an increased focus on strategic mergers and acquisitions. Companies operating in this market are constantly focusing on several strategies, such as mergers, acquisitions, and business expansions. These strategies will help them increase their revenue, thereby fostering the market’s growth.

• In April 2023, UnitedHealth Group's Optum and the parent company of SCA Health acquired physician groups from Kelsey-Seybold, Crystal Run Healthcare, Healthcare Associates of Texas, and Atrius Health. The acquisition focused on expanding services and supporting high-quality care with better experiences for patients and medical service providers.


• In April 2021, HCA Healthcare announced its plans to open a new multi-specialty Willis Surgery Center by 2022.

Similarly, many market players are involved in developing new and innovative solutions in ambulatory settings, which is expected to boost the U.S. ambulatory surgical centers market growth.

U.S. Ambulatory Surgical Centers Market Growth Factors

Growing Preference for Ambulatory Surgical Centers over Hospitals to Drive Market Growth

The gradual shift of surgical procedures from hospitals to these surgical centers is driving the market growth. The volume of surgeries being performed in ASCs has observed a major increase in the last few years. Moreover, a large number of patients preferring these settings for various orthopedic surgeries will also drive market growth. Factors such as shorter stays, use of innovative & new technologies in ambulatory settings, cost-effective surgical procedures, and fewer risks of infection will also boost the volume of surgeries in these settings.

• According to the study results published by UnitedHealth Group in December 2020, performing joint replacement surgeries in ASCs can save annual surgical expenditures worth up to USD 3 billion and can result in 500,000 fewer hospitalizations per year across the U.S.

Additionally, several benefits of these settings over hospitals are contributing to the market growth. These benefits include lower waiting time and less time taken to complete a surgical procedure. Furthermore, increasing investments in developing new ASCs is expected to drive the U.S. ambulatory surgical centers market growth during the forecast period.

Positive Reimbursement Scenario for Procedures in ASCs to Boost Market Growth

The availability of reimbursements for ASC procedures is one of the critical drivers for the market’s growth. The introduction of favorable policies for reimbursement are prompting the Centers for Medicare & Medicaid Services (CMS) to increase its list of surgeries that can be conducted in ASCs. Moreover, rising initiatives by commercial payers to encourage physicians to perform various surgical procedures in these settings are expected to drive market growth in the coming years. Furthermore, CMS constantly focuses on reviewing the complications associated with performing surgeries in these settings, thereby improving the safety of patients undergoing operations in ASCs.

• In June 2021, UnitedHealth Group committed to direct more surgeries toward ASCs by aiming to have more than 55% of outpatient surgeries and radiology services delivered at ASCs by 2030. Also, UnitedHealth Group has adopted certain policies that allow reimbursement of certain elective surgical procedures if they are conducted in these settings only.

Such intense focus of payers on the safety of surgical procedures in ambulatory settings can attract a large patient pool in the U.S. Thus, these factors are expected to propel market growth in the future.

RESTRAINING FACTORS

Several Disadvantages of ASCs to Limit Market Growth

A large patient pool in the U.S. is opting for outpatient surgical centers to undergo surgery over the past few years. However, several disadvantages of these settings might limit market growth during the forecast timeframe. These disadvantages include a shortage of facilities for overnight stay, complications & emergencies during surgical procedures, and no plans for contingencies. The difficulties in some surgeries may need the transfer of patients from ASCs to hospitals nearby. Thus, some of the patients opt for hospitals over ASCs to undergo surgery.

• According to the meta-analysis published by the Rush University Medical Center in April 2022, surgeries conducted in ASCs resulted in the following rates of complications: cardiac - 0.29%, vascular - 0.25%, pulmonary - 0.60%, gastrointestinal - 1.12%, and musculoskeletal/spine/operative - 0.59%.

The common complications encountered during surgical procedures in ambulatory settings include pain & nausea, impaired healing, and a higher risk of infections. Thus, such disadvantages of these settings are expected to hamper market growth during the forecast period.

U.S. Ambulatory Surgical Centers Market Segmentation Analysis

By Type Analysis

Single-specialty Segment to Hold a Dominant Share Due to Growing Cases of Ophthalmic Disorder

Based on type, the market is segmented into single-specialty and multi-specialty.

The single-specialty segment dominated the U.S. market in 2022 and is anticipated to continue its dominance during the forecast period. The dominance is attributed to the growing incidence of ophthalmic disorders and the strong presence of single-specialty ambulatory surgical centers in the U.S.

• For instance, in 2021, SurgCenter opened a new surgical center, the Advanced Surgical Care of Maryland. The surgery center operates in several applications, such as general orthopedics, sports medicine, outpatient total joint replacement surgery, and pain management.

The multi-specialty segment is projected to record a substantial CAGR during the forecast period. Factors such as the increasing number of surgical procedures related to ophthalmology, gastroenterology, and pain management are expected to boost the segment’s growth in the coming years.

By Ownership Analysis

Physician-owned Segment Leads Market Owing to Efficient Services in these Centers

Based on ownership, the market is segmented into hospital-owned, physician-owned, and corporate-owned.

The physician-owned segment accounted for the largest U.S. ambulatory surgical centers market share in 2022 and is expected to register a substantial CAGR in the coming years. Physician-owned ambulatory centers are quite common, as doctors own 100% equity in these surgical centers. The segment’s large share is attributed to factors, including physicians’ convenience while scheduling surgeries and increasing inclination toward this type of ownership by physicians in the U.S.

The corporate-owned segment is anticipated to record the highest CAGR during the forecast period of 2023-2030. The segment’s high growth rate is attributed to the increasing focus of management companies and physicians on forming a common joint venture. This ownership model is expected to gain popularity in the coming years as partnerships between corporate firms and physicians are emerging.

By Application Analysis

Surgical Services Segment to Continue its Dominance Due to Increasing Number of Surgical Procedures

Based on application, the market is segmented into surgical services and diagnostic services.

The surgical services segment dominated the market in 2022 and is expected to register the highest CAGR during the forecast timeframe. This segment's large share and high growth rate are attributed to the increasing number of surgical procedures in ambulatory settings. These procedures majorly include surgeries related to pain management, gastroenterology, ophthalmology, and orthopedics.

• According to a 2020 report by the Ambulatory Surgery Center Association, over 100,000 colorectal cancer screenings are performed annually in ASCs across the U.S.

The diagnostic services segment is estimated to record a moderate CAGR during the forecast period. The growth of this segment is attributed to the increasing number of patients opting for various diagnostic services in ambulatory settings. These diagnostic services include diagnostic colonoscopy and colorectal screening.

REGIONAL INSIGHTS

Based on geography, the market has been studied across the West U.S., South U.S., Middle West U.S., and Northeast U.S.

In 2022, the South U.S. held the highest share of the market. The market’s growth in this region is attributed to the strong presence of market players providing ambulatory services, a large patient pool requiring various surgical procedures, and an increasing number of ambulatory surgical centers in Alabama, Texas, and North Carolina.

West U.S. accounted for a significant share of the market. The growth of this region is attributed to the rising number of ambulatory surgical centers and the rising focus of market players in the transition of outpatient surgery departments to ASCs.

Middle West U.S. and Northeast U.S. are expected to grow at moderate CAGR during the forecast period. The rising number of procedures in orthopedics & gastroenterology, rising players’ initiatives, and the strong presence of ASCs in New Jersey, Pennsylvania, Illinois, Indiana, and Ohio and New York are expected to boost market growth during the forecast timeframe.

List of Key Companies in U.S. Ambulatory Surgical Centers Market

TH Medical to Hold Key Market Share in 2022 Due to Vast ASC Chains

The market is highly fragmented due to the presence of many companies offering ambulatory surgical services in the U.S. However, several key players, such as TH Medical, Surgery Partners, AMSURG (Kohlberg Kravis Roberts & Co. L.P.), and Surgical Care Affiliates, held a substantial share of the market in 2022.

TH Medical dominated the market in 2022. Its dominance is due to the large number of ambulatory surgical centers owned and operated by the company. For instance, according to the recently published data by VMG Health, in 2022, TH Medical owned and operated 440 ambulatory surgical centers.

Other companies, such as Constitution Surgery Alliance, SurgCenter, and Medical Facilities Corporation held substantial market shares due to their strong presence in the U.S. and the number of ASCs owned by them. Furthermore, strategic initiatives, such as mergers and acquisitions, are expected to increase their market shares in the coming years.

LIST OF KEY COMPANIES PROFILED:

• AMSURG (Kohlberg Kravis Roberts & Co. L.P.) (U.S.)


• TH Medical (U.S.)


• Surgery Partners (U.S.)


• SurgCenter (U.S.)


• Surgical Care Affiliates (U.S.)


• HCA Healthcare (U.S.)


• Physicians Endoscopy, LLC (U.S.)


• Covenant Physician Partners, Inc. (U.S.)


• Constitution Surgery Alliance (U.S.)


• Medical Facilities Corporation (U.S.)

KEY INDUSTRY DEVELOPMENTS:

• February 2023: Covenant Physician Partners, Inc. incorporated Artificial Intelligence (AI) in three of its locations across Hawaii. The AI is called the GI Genius and is used for enhanced colonoscopy screenings.


• July 2022: American Vision Partners collaborated with West Texas Eye Associates to provide best-in-class eye care and services to patients at an affordable cost.


• May 2021: Surgery Partners and UCI Health announced a strategic partnership that expanded community access to outpatient surgical facilities for approximately 4 million people throughout western Riverside County, Orange County, and southern California.


• January 2021: T.H. Medical announced that it had planned to acquire around 25 to 40 surgical centers in 2021. The company planned to spend an estimated USD 150 million on the acquisition of these centers.


• October 2020: Medical Facilities Corporation announced an agreement to sell its interest in Two Rivers Surgical Center to two managing physicians. This strategic move helped Medical Facilities Corporation to focus on utilizing its capital in various strategic initiatives.

REPORT COVERAGE

The report provides a detailed analysis of the market. It focuses on key aspects, such as leading companies, types, ownerships, and applications. Besides this, it offers insights into the latest market trends and highlights key industry developments. In addition to the factors mentioned above, the report includes the number of ASCs in key states, an overview of top surgical procedures in ambulatory settings, a comparative analysis of the average price and cost of elective procedures in ASCs & HOPDs, and analysis of the COVID-19 impact on the market.

Report Scope & Segmentation

ATTRIBUTE	DETAILS
Study Period	2019-2030
Base Year	2022
Estimated Year	2023
Forecast Period	2023-2030
Historical Period	2019-2021
Growth Rate	CAGR of 7.1% from 2023-2030
Unit	Value (USD Billion)
Segmentation	By Type Single-specialty Multi-specialty
By Ownership Physician-owned Hospital-owned Corporate-owned
By Application Diagnostic Services Surgical Services
By Region West U.S. South U.S. Middle West U.S. Northeast U.S.