Blog

Insights from an ASC Expert, by Scott Bacon & Chris Stai

This month’s "Insights from an ASC Expert" column is co-authored with Chris Stai, Managing Director of HREA | Healthcare Real Estate Advisors, a leading national healthcare real estate advisory group.  As a former Director for a publicly traded healthcare REIT, Chris has immense expertise in healthcare real estate and unique insights for navigating complex transactions. 

How do I maximize the value of the ASC real estate? 

Or rather, how do you maximize not only an investment in an ASC, but also the underlying real estate? The value of the ASC real estate can create significant investment returns for physicians, but only if the lease terms are structured properly. It’s a balancing act to ensure both investments, the ASC operating entity and the real estate holding company, are successful.  With current real estate valuations for ASCs ranging from a 5% - 6% cap rate, which is the equivalent of a 16.5x – 20x multiple, it is important to consider and plan around a couple of strategic variables in order to maximize value. 

Charles Dickens’ famous quote would aptly describe the past two years: “These are the best of times and the worst of times.”

These past two years have been the best of times because the industry is booming, with outpatient migration accelerating. Patients don’t want to go to hospitals and have recognized ASCs as a high quality, low cost, safe option for surgery.

Volumes are up across the industry, most notably in complex cases like total joint replacements. We had a record number of new projects (~250) announced in ‘21.

And it was the worst of times, given the fine people we lost along the way (like dear ASC friend Jon Trujillo) and the pervasively disruptive impact of COVID in all areas of our lives.  

Supply chain disruptions, staffing shortages, wage inflation, rising construction costs, changing regulations and more have all added complexity to our world.

Predictions

Attempting to predict the future is a fool’s errand. Indeed, I’m reminded of Plato’s famous quote from The Republic: “I am the wisest man alive, for I know one thing, and that is that I know nothing.”   

Despite that, a few trends are worth calling out:

October 28, 2021 - We just wrapped up a quarterly team meeting. But this one was special.

We celebrated 10 years of Compass with our staff and a few industry friends. Our theme: Honor Our History, Launch Our Future.

We gathered our team in Durham, NC, and spent time reflecting on our history. What makes Compass distinct? What have we done well? What foundations are important as we move into the future? We then moved to lock our plans for the future. What could be improved? How can we be more innovative? How can we become better leaders? We sought to answer these and many other questions.