SCA Health Expands ASC Joint Ventures
SCA Health, Optum's ambulatory surgery center (ASC) division, now partners with over 60 health systems and operates more than 370 specialty clinical care sites. The company's growth model is built on creating joint ventures that integrate specialty imaging with surgical services in ambulatory settings, a strategy other large health systems are expected to emulate.
- A key driver for shifting imaging to outpatient settings is Medicare's site-neutral payment policy, which aims to equalize reimbursement between hospital outpatient departments (HOPDs) and freestanding centers; proposed 2026 rules look to expand this, potentially impacting hospital revenues as commercial payors often follow Medicare's lead. - The U.S. ambulatory surgery center (ASC) market is projected to reach $205.52 billion by 2030, with orthopedics, cardiology, and spine surgery expected to account for 43% of volume growth between 2023 and 2028. - SCA Health's recent acquisitions include U.S. Digestive Health Management, a large gastroenterology group with 24 ASCs, and OrthoAlliance, a management services organization partnering with over 200 orthopedic physicians. - A study of Optum's strategy found its ASC acquisitions were associated with an 11% price increase for commercial insurers, driven by enhanced negotiating leverage from vertical integration. - The outpatient imaging boom faces a severe workforce crisis, with 2025 vacancy rates for CT technologists hitting a high of 19.4% and MRI technologists reaching 17.4%; demand for imaging is projected to outpace the supply of radiologists through 2055. - To mitigate staffing shortages, health systems are increasingly adopting AI; as of mid-2025, the FDA had approved approximately 873 AI algorithms for radiology, which assist in workflow triage and flagging abnormalities. - While SCA Health and Optum focus on acquiring physician practices and ASCs, competitors like HCA Healthcare are pursuing "greenfield developments," aiming to add 100 new outpatient facilities by the end of 2024 to its existing 148 centers. - Joint ventures between hospitals and imaging center operators have become a primary strategy for health systems to retain patient volume and gain operational expertise in lower-cost settings.
