Mergers and acquisitions remain a driving force in the ASC industry, as national operators, health systems and private equity firms seek scale, specialty depth and stronger physician alignment.
Here are 10 trends shaping ASC dealmaking in 2025:
- Valuations are stabilizing: ASC deal multiples are holding around eight times the operating income, signaling a maturing and more competitive M&A environment.
- Platform vs. turnaround plays: Buyers are split between acquiring thriving platforms to scale quickly and targeting underperforming centers for turnaround opportunities.
- Physician alignment drives deals: Equity-sharing models and surgeon leadership buy-in are now central to structuring ASC partnerships.
- Private equity is retooling: Firms are integrating ASCs with physician practice management groups and outpatient networks to capture more of the care continuum.
- Payer pressure accelerates consolidation: Commercial and government payers are steering more procedures into outpatient settings, creating stronger incentives for hospitals and physicians to partner with ASC chains.
- Independence may see a rebound: Some leaders predict hybrid models will grow, allowing physicians to retain ownership while accessing capital and support from strategic partners.
- Mega-deals reshape the field: Ascension’s agreement to acquire AmSurg will expand its ASC footprint from 58 to more than 300 centers.
8. High-acuity specialties attract buyers: Orthopedics, spine and GI continue to lead as the most sought-after ASC service lines.
9. Smaller ASCs still find success: Leaders say niche-focused centers with efficient operations can thrive outside large-scale rollups, indicating the centers may be better positioned to adapt to market demand.
10. Regulatory shifts shape deals: State certificate-of-need law changes and evolving federal payment policies continue to influence where and how ASC development and acquisitions occur.
