Physician Wholly Owned ASC – In this model, physicians own 100% of the operational entity and may either lease or own the real estate. Each physician investor receives income from operations based upon the number of shares or percentage of ownership in the entity. Physician owners are typically required to provide initial capital for the project as well as guarantee the entity debt. The physician owners enjoy the benefit of operational control and decision making for the ASC.

Physician – Hospital Joint Venture – In this model, physicians opt to joint venture the ASC with a hospital partner. Ownership percentages and control of operations are typically defined prior to project development and physician investment. Physician investors and the hospital partner both contribute capital and guarantee the debt based upon the percentage of ownership. This model can be very successful in markets where hospitals have a strong community presence and physicians practice patterns and referrals have been centered around the hospital.

Multi-specialty ASC – In this model, a wide range of procedures can be performed and all physician surgical specialties can be included as well as pain management and gastroenterology. This model provides the greatest opportunity for physician involvement. As much of the ASC equipment is specialty-specific, attention must be given to having sufficient volume representation for each contemplated specialty.

Single-specialty or limited–specialty ASC – In this model, a group of investors decides to limit the operations of the entity to either one or a limited number of specialties in which the prospective investors contribute a significant number of procedures. This serves to limit the capital investment required as the facility size is typically on a smaller scale and the facility is only equipped for designated specialties.