Reimbursement rate uncertainty and a regulatory landscape in flux won’t stand in the way of ambulatory surgery center (ASC) growth for Tenet Healthcare Corporation (NYSE: THC).
Tenet leaders continue to double down on the ASC market, with plans to prioritize capital investments to grow its subsidiary, United Surgical Partners International (USPI), through M&A over the next several months. Executives discussed those plans and more during the company’s 2025 third-quarter earnings call on Oct. 28.
“We have already spent nearly $300 million on M&A in this space year to date and expect to continue adding additional centers in the fourth quarter, as the M&A and de novo pipelines remain strong,” Dr. Saum Sutaria, chairman and CEO of Tenet, said on the call. “The ASC opportunity has many dimensions, given the growth platform we have built at USPI. We’re focused on higher-end specialties and partnerships with our more productive health system partners.”
Tenet’s ambulatory care segment reported Q3 2025 revenues of about $1.28 billion, up from $1.14 billion during the same quarter a year ago. This growth was driven by substantial same-facility net patient service revenues, acquisitions and an increase of 211 service lines.
The segment also reported an 11% increase in total joint replacements compared to the previous year.
As of Sept. 30, 2025, USPI had interests in 530 ASCs (398 consolidated) and 26 surgical hospitals (eight consolidated) in 37 states, according to Tenet.
Exploring the ASC pipeline
Through the third quarter, Tenet acquired 11 ASCs and opened two de novo centers, bringing its total to 556 facilities nationwide. Sutaria said it will continue investing in the ASC platform, allocating $250 million annually to M&A and de novo projects.
“We remain at an advantage in what it takes to develop and expand this segment,” Sutaria explained. “That’s what gives us the confidence to move forward, to spend more than we initially planned and to anticipate a strong pipeline in 2026.”
Physicians seek companies with a proven track record, demonstrated growth ability and a good reputation among peers, according to Sutaria. Single-specialty physicians want partners who can help diversify their practice, expand their centers and make them multispecialty practices, at which Tenet is uniquely positioned to excel, he said.
Even with regulatory uncertainties and a government shutdown possibly affecting reimbursements, the company is prepared for a busy November and December in its ASCs, with staffing and capacity plans in place for the annual increase.
“We’re not worried about capacity to take on the demand that we would see at the end of a typical fourth quarter,” Sutaria said. “At USPI, we begin planning for that every year, months in advance, with a well-established protocol. There should be no reason it’s different this year, including if there’s more demand.”
Health care exchange and regulation uncertainty
Sutaria stated that USPI is shielded from many of the Medicaid and health care exchange problems affecting other facilities, as its ASCs operate on standalone rates.
USPI ASCs have less exposure, on a per case or revenue basis, than the hospital segment because the exchange business typically exhibits consumption patterns similar to those of Medicaid.
Sun Park, executive vice president and chief financial officer, further noted that leadership remains confident in both capacity and ability to care for patients, and that for the third quarter, the exchange was responsible for 8.4% of total admissions and 7% of total consolidated revenues — a slight increase in total as a percentage of admissions from the second quarter.
However, the Centers for Medicare & Medicaid Services’ (CMS) Wasteful and Inappropriate Service Reduction (WISeR) model creates uncertainty for the ASC space due to questions about which services it will be implemented for, according to Sutaria.
He said in considering the model’s requirements, the company has identified three challenges: preparing documentation and understanding requirements, consistently applying those requirements, and managing scheduling in conjunction with preauthorization.
Yet he remains confident.
“We’re prepared for that,” Sutaria said. “We have a capable revenue cycle team within USPI that handles all the end-to-end services required, and we feel confident about that. In any marketplace, when these kinds of things are introduced, there’s usually an adjustment period.”
Then there’s the question of the inpatient-only list.
Sutaria said that if the list is retired, it could encourage more types of surgeries that used to be done in hospitals to move into ASCs. While he remains optimistic, he feels it is still early.
“I think this policy is still very much up in the air and not even at the point where I would say we’re engaging in rulemaking discussions about it,” he explained. “It definitely represents an opportunity.”
