Between the ASC megadeals of 2026 and more traditional practice acquisitions, a set of smaller transactions is changing who owns ASCs and why.
Over the past two months, a health plan has signed on as a co-owner of surgery centers, an antitrust order returned a GI center to its physicians and neurosurgeons have proposed selling a majority stake while keeping clinical control.
Here are five recent deals that break from the standard acquisition playbook.
1. CardioOne and CardioSphere
Denver-based CardioOne, a partner for physician-owned cardiology practices, joined forces with Warrenville, Ill.-based CardioSphere, a cardiovascular-focused management services organization, on Oct. 8. As part of the deal, CardioOne added Chicago-based Midwest Cardiovascular Institute to its network, which now supports more than 110 providers nationwide.
The model runs opposite to most cardiology consolidation. Rather than acquiring practices, the organizations help cardiologists leave hospital and corporate employment for independent practice, then build alignment with health systems through joint-venture ASCs, service line co-management, professional services arrangements and group practice structures.
2. EyeCare Partners
St. Louis-based EyeCare Partners agreed to sell its optometry business to Vienna, Va.-based MyEyeDr. in a deal announced in late September. The sale adds more than 300 offices to MyEyeDr.’s network.
For EyeCare Partners, the divestiture is a bet on surgery. The company plans to concentrate its resources on its ASC and ophthalmology businesses and use the proceeds to pay down debt, improve liquidity and strengthen its capital structure. Financial terms were not disclosed. The sale is expected to close in the fourth quarter, subject to closing conditions and regulatory approvals.
3. Penn Medicine, Independence Blue Cross and Regent Surgical
Philadelphia-based Penn Medicine, Independence Blue Cross and Franklin, Tenn.-based Regent Surgical plan to develop at least 18 ASCs across Pennsylvania, New Jersey and Delaware through a new company, the organizations announced Sept. 24. Timing and scope depend on regulatory approvals, community needs and market conditions.
The ownership structure is the departure. Penn Medicine provides clinical care, Independence Blue Cross contributes its perspective on member access and affordability, and Regent handles development and operations. Regent has never before had a payer as an owner in one of its ventures.
Regent CEO Travis Messina said he knows of no earlier ASC partnership that combined a health system, a health plan and a management company. He pointed to two drivers: the existing relationship between Penn Medicine and Independence Blue Cross, which co-own physician network Tandigm Health, and CMS’ 2026 phase-out of the inpatient-only list, which removes 285 procedures in its first year, 271 of which are also permitted in ASCs.
Mr. Messina told Becker’s he does not expect the insurer’s stake to materially change how the centers operate.
“Just because they’re an insurance company, it doesn’t mean that they’re any different than
4. Ascension, Amsurg and Florida Gastroenterology Center
St. Louis-based Ascension closed its $3.9 billion acquisition of Nashville-based Amsurg on Sept. 17, after the Federal Trade Commission finalized its consent order Aug. 31. To clear the deal, the FTC required Ascension to divest ASCs in five metro areas where the combination would reduce competition: Nashville, Panama City, Fla., Tulsa, Okla., Waco, Texas, and Wichita, Kan.
Most of the centers went to SC Affiliates, an affiliate of Optum’s SCA Health. One did not. Northwest Florida Gastroenterology Center in Panama City went to Florida Gastroenterology Center, a local physician group that already held a minority stake, returning the center to full physician ownership.
The order also requires Ascension and Amsurg to provide up to a year of transition assistance, including billing, credentialing and payer contract support, and places the divestitures under a compliance monitor. It runs for 10 years.
5. Atlas Surgery Center
Physician owners of Atlas Surgery Center in Amherst, N.Y., proposed selling 60% of their holdings to Ambulatory Partner Holdings for $54 million, an Atlas physician confirmed to Becker’s Aug. 27.
The center offers outpatient spine, neurovascular and brain tumor procedures, a rare mix for an ASC. Elad Levy, MD, a neurosurgeon with the University at Buffalo and Atlas, said the physicians would retain all medical decision-making if the sale goes through.
“Neurosurgery is the only subspecialty that has not embraced the outpatient arena. We set out to change that,” Dr. Levy said.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
