United Surgical Partners International

The FTC did require them to divest seven ASCs to clear antitrust concerns.

But with that done, Ascension is now right up there with Tenet's USPI as the largest ASC consolidator in the country.

Yeah, and I, I think that this consolidation is concerning to many of our listeners who are-

Mm-hmm

Everybody's betting on the same shift, just from opposite directions.

And there were a few other deals in the roundup too.

Sencora's $1.1 billion purchase of EyeSouth Partners' retina business back in March, Tenet's USPI doing about $125 million in acquisitions in the first quarter alone, and SSM Health taking a majority stake in Oklahoma Spine Hospital for $46 million.

So independent centers don't have to sell because consolidation is accelerating.

That being said, the other ancillary, I guess, specialty, if you will, that has captured the attention of private equity recently are the surgery center developers and management companies.

So for a long time, it's been USPI, SCA, Amsearch, right? Amsearch just got bought by Ascension.

And now it's, you know, a growing group of, you know, the next surgery center management companies that are private equity backed, looking to develop and buy and invest in surgery centers.

So if you are a physician group in a surgical specialty who has a surgery center that's options are growing in that you could sell your practice and your surgery center to, you know, if you're an orthopedics, one of the private equity backed platforms, or you could say, you know, I really want to keep my practice the way that I have it, but I have this surgery center.

It's very profitable.

Maybe we take some chips off the table that way and look at selling just the surgery center to one of the groups that I just described.

And by the way, USPI, SCA, Amsurge, still very much in the mix.

It's just this new sort of emerging group coming along and private equity has taken an interest there just given the...

And when you work with the administrators at ASCs, whether they're

your physician colleagues or they're a USPI or a physician's endoscopy company, how do you make the case to them or how would you advise to make the case to them to let's get these procedures started? There's a capital...

Investments, sometimes there's expensive disposables that may not reach their end of life before they're used, that sort of thing.

So what's the kind of conversation about the administrative and the financial part of bringing these

So they have to go through all of these reimbursable items.

It's also dependent on who is going to be the payer, whether it's government-related, whether it's private or self-paid, what have you.

and then the state that you're in right because all states have different uh things going for this so once you present you make your case this is i want to do procedure x and i'm going to have patients y and z and i'm anticipating doing 10 of this a week or 10 of this a month And then they start doing that, right? And then they will come up with a plan, like in my case was USPI, that will come up with a plan, say, okay, this is something that we can do.

They will talk to industry and then negotiate with industry what, you know, that price will look like.