Brentwood, Tenn.-based Surgery Partners is one of the country’s largest ASC operators, with more than 200 centers across 33 states.
In 2025, the company doubled down on high-acuity outpatient growth and recycled capital out of heavier hospital assets into de novos and physician-aligned platforms.
Here’s a deep dive into how the company shifted its strategy in 2025:
Choosing independence over a PE buyout
On June 17, Surgery Partners rejected a buyout bid from Bain Capital, its largest shareholder, and opted to remain independent. Bain, which owns about 39% of the company, offered a deal reportedly valuing Surgery Partners around $3.2 billion. The independent committee declined, citing strong standalone performance and more upside as a public company.
Chairman Brent Turner framed the decision as a bet on Surgery Partners’ platform in a “high-growth outpatient market” powered by its joint-venture model, M&A track record and favorable demographic and policy tailwinds. Bain’s leadership said it remained supportive as a long-term investor.
The structural limits of private equity may have influenced Surgery Partners’ move, Benjamin Stein, MD, CEO of Capital Surgical Solutions, said.
“Their ability to influence payer dynamics, manage population risk, or embed into a broader care continuum is inherently more limited,” Dr. Stein said. “Bain has had a substantial minority position in Surgery Partners to date, but I would imagine there is some hesitancy on this full acquisition moving forward as the downstream upside is not as clear.”
The move signals Surgery Partners’ confidence that it can outgrow PE-style return timelines by staying public and compounding physician-partnered development.
Outpatient-focused hospital growth
Surgery Partners and Baylor Scott & White Health formed a joint venture to co-own the Physicians Centre Hospital, a 16-bed physician-owned surgical facility in Bryan, Texas. Baylor Scott & White now holds an ownership stake alongside Surgery Partners and the hospital’s physician investors, while Surgery Partners continues to manage operations. Leaders described the deal as a way to expand surgical access amid rapid population growth in the Brazos Valley.
“The new joint venture integrates our patient-centric hospital with one of the nation’s most respected health systems and provides the opportunity to serve additional patients, attract new physician partners and broaden our breadth and depth of services,” Jennifer Baldock, executive vice president at Surgery Partners, said.
Scaling back its revenue forecast
On a Nov. 10 earnings call, Surgery Partners revised full-year guidance downward to about $3.2 billion to $3.3 billion in revenue and $535 million to $540 million in adjusted EBITDA. CEO Eric Evans said the change reflected delayed capital deployment, timing of ASC sale proceeds, and a more cautious view of fourth-quarter payer mix and volume, especially amid softer-than-expected commercial volumes.
Management noted that about 60% of the reduction was tied to slower deal deployment and divestiture timing, with the remaining roughly 40% due to mix/volume headwinds. Year-to-date, the company deployed $71 million toward acquisitions and completed three ASC divestitures, generating around $45 million in cash and paying down debt.
Orthopedic and de novo focus
Surgery Partners leaned hard into de novo development in 2025, emphasizing “focus factory,” high-acuity sites, especially in orthopedics and cardiology. Mr. Evans said these facilities allow the company to negotiate payer rates based on hospital migration economics and concentrate expertise in core service lines.
The company opened two de novos in the third quarter, has nine under construction and more than a dozen in development, which are largely ortho-heavy and higher acuity. It also added about 500 physicians, with many in orthopedics, supporting growth in total joint and spine procedures.
Portfolio optimization and divestitures
Alongside growth, the company continued to prune “non-core hospital assets” with higher capital intensity through divestitures or partnerships, with a goal of reducing leverage and improving cash flow, Mr. Evans said.
M&A focus
Surgery Partners has invested around $71 million in capital for acquisitions so far this year, adding multiple facilities to its portfolio. It also sold stakes in three ASCs for about $50 million.
“Our disciplined approach prioritizes long-term value over short-term gains,” Mr. Evans said. “Importantly, the near- and mid-term pipeline remains robust, with over $300 million in opportunities under active evaluation. We are focusing on deploying capital strategically in the months ahead and anticipate a return to normal levels on annual capital investment.”
