Cincinnati-based Bon Secours Mercy Health affiliate HealthSpan Partners agreed Oct. 26 to acquire Brentwood, Tenn.-based Surgery Partners in an all-cash deal valued at about $5.7 billion, including debt. The deal is expected to close in the first quarter of 2027, pending shareholder and regulatory approvals.
Surgery Partners has about 5,000 affiliated physicians and more than 200 locations across 30 states. It will keep its name, brand and headquarters, and “will remain a secular organization and will not be treated as a Catholic ministry.”
The company holds its facilities through partnerships or limited liability companies with physicians, physician groups and health systems, according to its 2025 annual report. As of Dec. 31, 2025, it held majority ownership in 90 of its 176 surgical facilities and consolidated 121. Surgery Partners already co-owns the Physicians Centre Hospital in Bryan, Texas, with Baylor Scott & White Health and the hospital’s physician investors.
Most ASCs are at least partly physician-owned, but corporate ownership is growing. The number of ASCs owned by the five largest corporate operators rose 15.7% from 2018 to 2023, to 1,333, according to MedPAC data.
ASC leaders responding to the deal said physicians need to keep a central role in how centers are run.
“The systems that succeed will be the ones that embrace, not disrupt, the physician-led governance that makes ASCs work,” said Steve Hockert, chief development officer of Southlake, Texas-based Solara Surgical.
Leo Spector, MD, CEO of Charlotte-based OrthoCarolina, said the ASCs that succeed will be those where surgeons have “a real voice in how patient care is delivered,” whether a center is owned by a health system, investors or surgeons.
Megan Friedman, DO, chair and medical director at Los Angeles-based Pacific Coast Anesthesia Consultants, said physicians “need to be actively involved in operational and strategic decision-making, not simply expected to adapt to decisions made at the corporate level.”
Raghu Reddy, chief administrative officer of Southfield, Mich.-based MiOrtho Surgery Center, said physician partners will want answers on “how syndicated ownership will be treated, whether referral patterns will shift and whether the system’s ethical directives will affect any service lines.”
Federal rules require each ASC to have a governing body with full legal responsibility for its operations. In joint ventures, ownership and board control don’t have to line up.
“Hospitals can own a majority share but the physicians can hold the majority of the governing board seats,” Joe Zasa, managing partner of ASD Management, told Becker’s. Amending an operating agreement generally requires a supermajority board vote, often 75%. Each investor class can also hold reserved powers, such as a hospital’s right to limit the types of cases an ASC performs.
Hospital systems often push for 51% ownership, which can erode physician autonomy even when they promise local control, Jeffrey Flynn, administrator and COO of New York City-based Gramercy Surgery Center, told Becker’s.
“If you were looking to lose autonomy, that’s exactly what’s going to happen,” he said.
Hospitals typically need majority ownership to control payer contracting, ECG Management Consultants principals John Fink and Naya Kehayes wrote in Becker’s.
Ownership terms also carry compliance stakes. Under the federal ASC safe harbor, at least one-third of each physician investor’s medical practice income must come from ASC procedures. In multispecialty centers, physician investors must also perform at least one-third of their ASC procedures at the center where they invest. Meeting a safe harbor is voluntary. Surgery Partners said that its facilities “will not fully satisfy the ASC safe harbor requirements.”
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.
