Over the past five years, health systems, private equity firms and corporate giants have poured billions into the ASC market, snapping up physician-owned centers and building platforms from scratch.
From Ascension’s near-$4 billion grab for AmSurg to Cardinal Health’s bet on GI, here are 10 major ASC market moves since 2021:
1. Ascension acquires AmSurg (~$3.9 billion, 2025)
In June 2025, St. Louis-based Ascension announced a definitive agreement to acquire Nashville, Tenn.-based AmSurg, one of the largest ASC chains in the country, with 250 centers and partnerships with more than 2,000 physicians. Valued at approximately $3.9 billion and expected to close in 2026, the deal will expand Ascension’s ASC footprint from 58 to more than 300 centers across 34 states — a nearly fivefold leap that puts it in direct competition with Tenet Healthcare’s United Surgical Partners International, the current market leader.
2. Cardinal Health acquires majority stake in GI Alliance (~$2.8 billion, 2024)
In November 2024, Cardinal Health announced it would acquire a 71% majority stake in GI Alliance, the country’s leading gastroenterology management services organization, for approximately $2.8 billion in cash. The sellers included GIA physician owners and funds managed by affiliates of Apollo Global Management, which had previously backed the platform. The move signals Cardinal Health’s ambitions to expand well beyond its distribution roots and into specialty care delivery.
3. USPI acquires SurgCenter Development (~$1.2 billion, 2021)
In November 2021, Dallas-based United Surgical Partners International announced it would acquire SurgCenter Development and its more than 90 ASCs for approximately $1.2 billion. The deal covered ownership interests in 92 centers across 21 states, with a heavy concentration in high-growth markets like Arizona, Florida and Texas, and included a five-year development agreement to continue building new facilities. About 80% of the acquired centers specialize in musculoskeletal care, including spine and total joint procedures, aligning with USPI’s core strengths. The acquisition pushed USPI’s total portfolio to more than 440 ASCs, cementing its position as the nation’s largest ASC chain.
4. Omers Private Equity acquires Gastro Health (~$950 million, 2021)
In 2021, Canadian pension fund Omers Private Equity acquired Miami-based Gastro Health in a deal valued at an estimated $950 million. The transaction was one of the largest GI-focused ASC deals on record at the time and underscored growing investor interest in gastroenterology platforms, which combine high procedure volume with favorable reimbursement trends.
5. Surgery Partners raises $800 million equity offering (2022)
In 2022, Surgery Partners executed an $800 million equity offering, one of the largest capital raises in the ASC sector in recent years. The proceeds were earmarked for acquisitions and de novo facility development, reflecting the company’s aggressive growth posture as it competes with larger chains like USPI and SCA Health.
6. Apollo Global Management GI Alliance recapitalization (~$785 million, 2022)
In 2022, Southlake, Texas-based GI Alliance secured a $785 million recapitalization from Apollo Global Management. As part of the transaction, physician owners agreed to repurchase a minority equity stake of approximately 30% from Waud Capital Partners, the platform’s prior private equity backer. The deal illustrated the escalating valuations in the GI space and set the stage for Cardinal Health’s larger acquisition two years later.
7. USPI acquires Covenant Physician Partners (2024)
In early 2024, USPI quietly purchased Covenant Physician Partners, a multispecialty physician group with a significant ASC footprint. The deal came after Covenant’s PE owner KKR faced mounting financial pressure, including elevated labor costs and rising interest rates, and opted to pay off lenders rather than pursue a distressed debt exchange.
8. Tenet acquires Baylor Scott & White’s stake in USPI ($406 million, 2022)
In 2022, Tenet Healthcare paid $406 million to acquire Baylor Scott & White’s 5% ownership stake in USPI, giving Tenet full control of the ASC giant. The move consolidated decision-making authority and removed a major institutional partner at a time when Tenet was doubling down on its outpatient growth strategy.
9. SCA Health acquires National Cardiovascular Partners (2023)
In December 2023, SCA Health — the ASC arm of UnitedHealth Group’s Optum — purchased National Cardiovascular Partners from Fresenius Medical Care, picking up 21 cardiac catheterization and vascular labs. Fresenius framed the divestiture as part of a broader strategy to exit non-core businesses and redirect capital toward higher-growth areas.
10. Bon Secours Mercy Health and Compass Surgical Partners JV expansion (2025)In 2025, Cincinnati-based Bon Secours Mercy Health and Raleigh, N.C.-based Compass Surgical Partners expanded their existing joint venture with plans to develop 30 new ASCs across seven states, including Kentucky, Ohio, Virginia and Florida. While not a traditional acquisition, the deal stands out as a notable example of the broader trend of health systems partnering with specialized ASC operators to scale their outpatient footprint.
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.