UnityPoint Health and the Iowa Clinic, both based in West Des Moines, Iowa, have filed civil claims against each other over the sale of the Iowa Clinic’s stake in Lakeview Surgery Center, a jointly owned outpatient practice. The dispute centers on a valuation gap of more than $12 million and is now before the Iowa Business Specialty Court.
Lakeview Surgery Center opened in 2002 and has been jointly owned and operated by the two systems under a 2000 operating agreement, according to court documents. In May 2025, the Iowa Clinic exercised its contractual right to sell its 50% share to UnityPoint. UnityPoint’s appraiser valued the clinic’s stake at $10.7 million; the Iowa Clinic’s appraiser put it at $38.3 million.
Under the operating agreement, when two independent appraisals diverge by 10% or more, a third appraiser is engaged and the final price is set as the average of the two closest valuations. Georgia-based Coker Group served as the third appraiser and filed its report in April, valuing the Iowa Clinic’s stake at $37.3 million — producing the $37.8 million figure the clinic says it is owed.
UnityPoint has argued that Coker Group’s report should be disregarded entirely. According to court filings, the original contract set a deadline for completing the third evaluation that UnityPoint says expired in February — before Coker finished its work. The health system says it never agreed to waive the deadline and that only the two original appraisals can be considered under the plain language of the contract.
The Iowa Clinic disputes that account. In its counterclaim, the clinic argues that UnityPoint executives were aware of the delay and repeatedly agreed, in writing, to allow Coker to complete the appraisal. The clinic contends that had UnityPoint signaled it would not extend the deadline, both Coker and the Iowa Clinic would have met the original date.
The Iowa Clinic’s counterclaim also raises a broader grievance, alleging that UnityPoint engaged in a deliberate strategy of directing its physicians to its own facilities rather than Lakeview during their partnership — effectively “free riding” on the joint venture at the Iowa Clinic’s expense. The clinic also noted that UnityPoint filed its complaint one year after the Iowa Clinic opened a competing surgery center in Waukee, Iowa.
In a statement shared with Becker’s, UnityPoint said it’s long-standing relationship with The Iowa Clinic remains collaborative and intact.
“As with any long-standing relationship, there are times when we see certain issues differently. As we work through the acquisition of Lakeview Surgery Center, UnityPoint Health has filed a lawsuit to resolve a disagreement regarding the transaction,” the statement reads. “This disagreement does not impact operations or patients at the Lakeview Surgery Center, and it does not impact our mutual commitment to ensuring that Lakeview Surgery Center continues to provide the best possible care to our collective patients throughout central Iowa.”
The Iowa Clinic echoed a similar sentiment in a statement it shared with Becker’s.
“This dispute is purely financial. It will not impact our commitment to exceptional patient care at Lakeview Surgery Center, which will continue to operate as usual. The Iowa Clinic looks forward to enforcing our rights in court.”
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.
