Two major deals on June 17 are poised to reshape the competitive landscape of ASCs: Ascension’s definitive agreement to acquire AmSurg, and Surgery Partners’ rejection of a buyout bid from Bain Capital.
The developments surrounding Ascension and Surgery Partners come amid rising tension between growth and control in the ASC industry. With over 11,500 ASCs in the U.S., many still independently owned, the sector remains ripe for acquisition, drawing continued interest from private equity giants like Bain Capital, TPG, and Optum all of whom explored a Surgery Partners deal in 2024.
On June 17, St. Louis-based Ascension announced a definitive agreement to acquire Nashville-based AmSurg, one of the largest ASC chains with 250 centers and partnerships with over 2,000 physicians.
The acquisition will expand Ascension’s ASC footprint nearly fivefold, from 58 to over 300 centers, across 34 states, transforming it into a top-tier player rivaling Tenet Healthcare’s United Surgical Partners International.
“We have 58 ASCs. This is going to add another 250, so it’s going to give us a good presence in 34 states,” Ascension President Eduardo Conrado told Becker’s. “And AmSurg has a great management team. They’ve got an operational platform that mirrors their areas of focus, which is quality, clinical engagement, and patient experience — in a segment [the ASC market] that’s growing 9% to 12% over the next five years. So, everybody’s very excited about coming up on this next step.”
In a June 17 news release, Ascension’s CEO Joe Impicciche framed the move as mission-aligned, expanding access to affordable, localized care and enhancing outpatient capacity as procedures like orthopedics and cardiology continue shifting out of hospitals.
The deal mirrors Tenet’s own aggressive strategy, which saw the health system divest hospital assets while growing USPI to more than 500 ASCs and 25 surgical hospitals.
With an anticipated close in late 2025 or early 2026, Ascension’s AmSurg acquisition marks a turning point in its ambulatory care strategy and signals broader consolidation ahead, especially as hospital ownership of ASCs has doubled over the last five years.
Surgery Partners rejects Bain’s buyout bid
Just as Ascension accelerates into the ASC space, Brentwood, Tenn.-based Surgery Partners is choosing a different path: independence. On the same day Ascension’s deal was announced, Surgery Partners rejected a takeover proposal from Bain Capital, reaffirming its intent to remain a publicly traded, independent company.
Bain, which already owns 39% of the company, valued the offer at $3.2 billion, but Surgery Partners’ independent board deemed the offer insufficient given its strong financial outlook, growth potential and strategic partnerships.
“Surgery Partners offers a unique, scaled platform in the high-growth outpatient surgical care market that leverages its proven joint venture model, strong M&A track record and favorable demographic and policy tailwinds,” Brent Turner, chairman of the independent committee, said in a news release.
Bain has backed Surgery Partners since 2017, helping to expand its network via acquisitions and de novo development. But private equity’s deepening role in the ASC market has triggered alarms among physicians and industry leaders concerned about consolidation’s impact on care quality, competition and physician autonomy.
“This is a textbook example of how private equity firms are consolidating their hold over healthcare in general, and the outpatient surgery business in particular,” Shakeel Ahmed, MD, CEO of Atlas Surgical Group in St. Louis, told Becker’s about the potential deal last year. “This merger will again glaringly outline the negative impact that private equity has had over our business. Not only will this limit fair trade and good patient care, by prioritizing financial returns over quality care and fair competition, private equity would continue to negatively impact our business.”
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