Some of the country’s largest health systems have spent the past two years selling hospitals and redirecting capital to ASCs.
In 2026, that shift has produced a $3.9 billion megadeal alongside a steady stream of single-site builds.
Here are the six largest health system ASC investments announced, closed, broken ground on or opened between January and September, ranked by disclosed dollar value. The list includes only ASC-anchored deals and projects.
1. Ascension (St. Louis): $3.9 billion
Ascension completed its $3.9 billion acquisition of Nashville, Tenn.-based AmSurg June 4, expanding its network to 300 ASCs. The deal closed two days after the Federal Trade Commission cleared it on the condition that Ascension divest seven AmSurg facilities. Six of those centers went to SC Affiliates, an Optum subsidiary.
“Healthcare is increasingly moving beyond the traditional hospital setting, and this acquisition positions us to lead that transformation,” said Eduardo Conrado, president and CEO of Ascension.
2. Tenet Healthcare (Dallas): $125 million
Tenet spent $125 million acquiring seven ASCs in the first quarter through Dallas-based United Surgical Partners International, reaching half of its $250 million annual acquisitions target for the ASC subsidiary in three months. USPI held interests in 538 ASCs and 26 surgical hospitals across 37 states as of June 30.
Saum Sutaria, MD, chair and CEO of Tenet, said the company remains selective and has a robust pipeline of centers interested in joining USPI this year.
“We still say no to more centers than we say yes to,” Dr. Sutaria said.
3. UM Health-Sparrow (Lansing, Mich.): $60 million
UM Health-Sparrow broke ground June 22 on a $60 million ASC in Lansing, a project the University of Michigan Board of Regents approved in February alongside an $83 million behavioral health hospital. The center will open in 2028 with four operating rooms and space to expand, along with a new MRI unit.
The ASC will take on procedures now performed at the system’s St. Lawrence campus and cases from its Lansing hospital, where operating room capacity is nearing its limit.
4. WVU Medicine United Hospital Center (Bridgeport, W.Va.): $48 million
United Hospital Center, part of Morgantown, W.Va.-based WVU Medicine, broke ground in February on a $48 million, 62,000-square-foot outpatient surgery center. The facility will have eight robotic-capable operating rooms for orthopedic and spine procedures, including same-day total joint replacements, plus shelled space for future growth. It will eventually connect to the main hospital.
5. Lee Health (Fort Myers, Fla.): $42 million
Lee Health began construction on a $42 million, 60,000-square-foot pediatric surgery center on the campus of Golisano Children’s Hospital of Southwest Florida and HealthPark Medical Center. The center is expected to open in early 2028.
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.
