Franklin, Tenn.-based Community Health Systems is making a decisive pivot toward ASC growth.
The nation’s largest for-profit hospital operator by facility count has spent recent years shedding underperforming hospitals, divesting seven in 2025 alone, while simultaneously doubling down on outpatient surgical capacity. The strategy reflects a broader industrywide trend — as payers push procedures to lower-cost settings and patients demand more convenient care, inpatient-heavy portfolios are beginning to be seen as a liability rather than an asset.
CEO Kevin Hammons summed up the company’s rationale directly in an April 20 news release: “Our targeted investments in ambulatory surgery centers extend our ability to provide care in the most advantageous way for our patients. By offering additional services through these outpatient settings, we are driving growth for our health systems, delivering quality care and excellent outcomes, and optimizing the surgical experience for both our physician partners and their patients.”
In 2025, the ASC market continued to solidify its role as a core site of care for elective and increasingly complex outpatient procedures, with growth driven by steady operator expansion, ongoing industry consolidation and favorable regulatory tailwinds. On the policy front, the CMS 2026 final rule added 560 newly approved ASC procedures, including lumbar spinal fusion, cardiac ablation and vascular procedures.
Health systems are increasingly treating ASC networks as critical to their financial strategy, centralizing ambulatory oversight at the executive level and investing in high-growth or underserved markets. CHS’ moves in Alabama and Alaska fit within that playbook.
Alabama
Alabama has emerged as the epicenter of CHS’ ASC buildout. In first quarter of 2026 alone, the company opened two de novo centers and announced what its CEO called the company’s largest purchase since 2016: a pending acquisition of a majority ownership interest in Surgical Clinic Solutions, doing business as Surgical Institute of Alabama, in Vestavia Hills. The freestanding, multispecialty center performs more than 8,000 cases annually across six operating rooms and two procedure rooms. Surgical specialists deliver neurospine, spine, orthopedics, total joint reconstruction, general surgery, urology and pain management procedures. The transaction is expected to close in the second quarter, pending customary conditions, though financial terms are not disclosed.
When it does close, CHS affiliate Grandview Health in Birmingham will operate four ASCs. The Birmingham Musculoskeletal Institute at Grandview Health, which opened in April 2026, joined Grandview Urology Surgery Center and Grandview Endoscopy Center on the campus of Grandview Medical Center.
CHS affiliate Baldwin Health in Foley is also expanding its outpatient presence. The system opened a de novo specialty surgery center in February 2026 offering orthopedic, gastroenterological and pain management procedures, while simultaneously completing a $154 million hospital expansion that added a five-story, nearly 200,000-square-foot tower, doubled ICU beds, added a Level II NICU and expanded operating suite capacity.
Alaska
Effective April 1, a CHS subsidiary completed the acquisition of a majority interest in South Anchorage (Alaska) Surgery Center. The center specializes in gastrointestinal and interventional pain procedures and is designed to support surgical capacity for CHS affiliate Mat-Su Regional Medical Center in Palmer.
The broader context
CHS is not alone in the race toward ASC scale. Tenet Healthcare’s ASC arm is the largest ASC operator in the country and held interests in 533 ASCs as of year-end 2025. The company invested nearly $350 million in M&A and de novo development during the year alone. Against that backdrop, CHS’ 37-center ASC network remains relatively small, but the pace of deal-making suggests leadership sees the gap and is moving to close it.
CHS’ first quarter 2026 financial results were mixed. Adjusted EBITDA fell 17.8% year over year, weighed down by a $50 million drag from recently divested hospitals. But management maintained full-year guidance, arguing that new ASC investments would largely offset the revenue lost from hospital divestitures. In CHS’ evolving portfolio, ASCs are not a supplement to the hospital business, but are increasingly its future.
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.