Private equity remains active in healthcare, including in the ASC ecosystem, but the strategy is shifting.
Rather than building standalone ASC platforms, firms are increasingly pairing ASC investments with physician practice management infrastructure to control patient flow across the care continuum and diversify revenue, according to VMG Health’s “2025 Healthcare M&A Report.”
Additionally, Bain & Co.’s “Global Healthcare Private Equity Report” highlights a growing focus on specialties in which scale, clinical coordination and cost management can improve outcomes and economics. While physician groups now account for a smaller share of total provider deals than at their 2021 peak, Bain notes they remain a core private equity portfolio asset, particularly in the U.S. middle market, where investors are prioritizing operational sophistication over pure roll-up strategies.
Here are five deals that illustrate where the market is headed:
1. Investor-backed MSOs are launching around groups that already have ASCs.
Evolve Orthopedic Partners formed as a physician-led MSO backed by Zenyth Partners and launched with OrthoNY as its foundational partner. The model signals continued investor interest in building management platforms around large specialty groups. This affirms VMG’s assessment that private equity is increasingly aligning MSO infrastructure with outpatient site-of-care assets like ASCs rather than pursuing ASC-only platform builds.
Bain’s analysis suggests this approach reflects a broader shift away from “loose confederations” of practices toward integrated platforms with shared infrastructure, standardized operations and a clearly defined role for the center. In capital-intensive specialties such as orthopedics, this integration supports both ASC utilization and readiness for future value-based payment models.
2. Strategic buyers are paying for PE-built specialty MSOs.
Cardinal Health’s multispecialty MSO, The Specialty Alliance, agreed to buy Solaris Health, a private equity-backed urology MSO, for about $1.9 billion. The transaction underscores a widening buyer pool for scaled physician assets, with distributors and other nontraditional strategic buyers joining payers and health systems in pursuing vertically integrated provider platforms.
The report points to this deal, and others involving Cardinal Health, Cencora and McKesson, as evidence that exit pathways for physician platforms are expanding beyond traditional PE buyers. In particular, distributor interest reflects the strategic value of controlling specialty drug utilization, site-of-care decisions and ancillary services.
3. Large physician platforms are still producing premium exits.
Pharmaceutical distributor Cencora agreed to acquire a majority stake in OneOncology from private equity backer TPG for roughly $3.6 billion. The deal highlights why platform formation is central to PE’s strategy. According to the “U.S. Healthcare M&A Mid-Year 2025 Report, published by healthcare advisory firm HealthValue Group, large platforms are attracting investors with scaled networks with standardized operations, and diversified revenue streams can attract strategic acquirers willing to pay for reach and infrastructure.
Platforms that can show sustainable growth and employer-of-choice positioning for clinicians are better positioned for sponsor-to-sponsor sales or strategic exits as more PE-owned assets reach fund maturity, according to the Bain report.
4. Real estate monetization is becoming part of the outpatient growth toolkit.
Fengate Asset Management purchased 24 medical outpatient facilities from a major U.S. nonprofit health system under a sale-leaseback agreement, adding more than 900,000 square feet across two states. Sale-leasebacks have become an increasingly used option for outpatient operators and ASCs to unlock liquidity while retaining operational control, capital that can be redeployed into growth, de novos or M&A.
5. PE is leaning into lower reimbursement risk and consumerized medicine.
Revelstoke Capital Partners acquired Griffin Concierge Medical, a physician-owned, membership-based practice in Tampa, Fla. The deal reflects growing investor focus on categories with less reimbursement exposure, and on wellness and access offerings such as preventive screenings, diagnostics, hormone optimization and weight management that can drive recurring cash-pay revenue.
The Bain report identifies similar “pockets of opportunity” in high-growth, consumer-facing specialties — including behavioral health, plastic surgery and dermatology — in which ancillary expansion and patient engagement models can strengthen practice economics.
