Recently proposed changes from federal regulators have ambulatory surgery center (ASC) executives feeling good about 2026.
Tenet Healthcare Corp. (NYSE: THC) leaders said on Tuesday that proposed federal changes to the Medicare Inpatient Only (IPO) list could further strengthen the company’s ASC business, particularly in higher-acuity specialties like orthopedics and spine, for instance.
“You know, we’ve seen higher acuity, good case mix, good payer mix, good growth in some of our key case lines, service lines, including ortho and total joints,” CFO Sun Park said on Tenet’s 2025 second-quarter earnings call. “That’s why you saw the strong net revenue overall growth of 7.7% as well as a strong net revenue per case.”
And with the U.S. Centers for Medicare & Medicaid Services (CMS) considering eliminating the IPO list as part of its 2026 payment rule, more procedures could shift from hospitals to outpatient settings.
CEO Saum Sutaria said the proposed rule could play to the company’s advantage.
“This move is positive,” Sutaria said. “At the same time, you know, it takes work and experience in higher-acuity ASC procedures to actually be able to successfully move those [cases] from an inpatient setting to an outpatient setting, and … the patient-selection criteria and expertise makes a big difference there so that you’re doing the right things clinically.”
Those are all areas in which Tenet is “pretty advanced as an ASC operator and platform,” the CEO noted.
“So I think it plays to our advantages,” Sutaria continued. “I think it represents an opportunity for the future, for sure.”
Tenet’s ambulatory subsidiary, United Surgical Partners International (USPI), added eight new centers in Q2, several of which specialize in spine, orthopedics and neurosurgery. Total joint replacements in USPI facilities increased 12.6% year over year, Sutaria said.
For the quarter ended June 30, Tenet reported $5.3 billion in net operating revenue and $1.12 billion in consolidated adjusted EBITDA, a 19% increase from last year.
Sutaria reaffirmed Tenet’s plan to exceed USPI’s baseline M&A spend of $250 million in 2025 and noted that Tenet’s revenue cycle platform, especially within its ambulatory business, has benefited from technology upgrades, offshore support and AI-powered documentation tools.
“We’re really pleased with the platform that’s being built for the ASC revenue cycle within USPI,” he said.
As of June 30, USPI had interests in 521 ASCs (385 consolidated) and 26 surgical hospitals (eight consolidated) in 37 states, according to Tenet.
Looking at just Tenet’s ambulatory care business, the segment brought in $1.27 billion in net operating revenues in Q2 2025, a more than 11% increase compared to $1.14 in Q2 2024. Tenet’s same-facility surgery case count at the end of Q2 2025 was 482,109, down by more than 5,000 cases compared to the prior year’s same period.
CMS usually releases the upcoming year’s final payment rule for ASCs around early November.
Tenet and other ASC players will be eagerly awaiting that annual milestone.
“Obviously enabling additional innovation in the ASCs is positive for the USPI business,” Sutaria said.
