The ASC industry has seen a wave of transformative transactions in 2025.
Three major moves are reshaping the competitive landscape and redefining what’s at stake for patients, physicians and payers:
1. Optum’s SCA Health acquires U.S. Digestive Health
In January, Optum subsidiary SCA Health quietly completed the acquisition of U.S. Digestive Health, one of the nation’s largest gastroenterology physician groups, from Amulet Capital Partners. UnitedHealth Group confirmed the deal to The Philadelphia Inquirer, highlighting a shared commitment to “quality-driven, high-value and innovative care.”
U.S. Digestive Health — formed in 2019 through the consolidation of three regional practices — includes more than 250 gastroenterology providers, 40 sites and 24 ASCs across Pennsylvania and Delaware.
Industry reaction has been divided. Some leaders are excited about how the acquisition could streamline care.
“My overall impression is that this is going to be a positive influence on outpatient care and ASC market in general,” Shakeel Ahmed, MD, CEO of St. Louis-based Atlas Surgical Group, told Becker’s. “While I lament the impending demise of private practice gastroenterology, I feel that these high-level mergers do help improve patient care and access. By bringing a large GI practice under the Optum umbrella, SCA can leverage their care and offer their value-based contracts to the medical practices.”
Others worry about corporate influence.
“The continued acquisition of medical practices by large corporations, whose focus is on profits and Wall Street, will continue to have a chilling effect on clinicians and ultimately, patients,” Alejandro Badia, MD, founder and CMO of Miami-based Badia Hand to Shoulder Center, told Becker’s. “The Optum takeover of a major GI medicine network will likely lead to greater disincentive when compared to traditional private practice where the clinician makes virtually all decisions, for better or worse.”
2. Surgery Partners rejects Bain’s buyout bid
While consolidation accelerates across the ASC industry, Brentwood, Tenn.-based Surgery Partners is taking the opposite approach: independence. Surgery Partners rejected a $3.2 billion takeover proposal from Bain Capital, despite Bain already owning 39% of the company. The company’s independent board cited strong growth prospects and strategic partnerships as reasons for turning down the offer.
Brent Turner, chairman of the independent committee, said in a statement:
“Surgery Partners offers a unique, scaled platform in the high-growth outpatient surgical care market that leverages its proven joint venture model, strong M&A track record and favorable demographic and policy tailwinds.”
Physicians and industry observers, however, remain wary of private equity’s role in the ASC market. Critics argue that prioritizing investor returns risks diminishing care quality and physician autonomy.
3. Ascension to acquire AmSurg in $3.9B deal
Perhaps the most defining move of 2025: St. Louis-based Ascension has signed a definitive agreement to acquire Nashville-based AmSurg, one of the nation’s largest ASC operators with 250 centers.
The acquisition will expand Ascension’s ASC footprint from 58 to more than 300 centers across 34 states, positioning the Catholic health system as a direct competitor to Tenet Healthcare’s United Surgical Partners International. The deal, reportedly valued at $3.9 billion, is expected to close in late 2025 or early 2026.
Industry leaders see the move as a turning point:
“This transaction reflects a broader recalibration among health systems, which are increasingly recognizing the imperative to pivot more aggressively toward the ambulatory surgical setting,” said Benjamin Stein, MD, CEO of Capital Surgical Solutions.
Unlike private equity consolidators, health systems bring payer integration, managed care contracts and value-based infrastructure, all critical for scaling ASCs.
Industry reactions range from excitement to caution. Some leaders see it as a long-overdue move to catch up with outpatient demand, while others warn Ascension must preserve AmSurg’s physician-centric culture rather than impose a hospital-centric model.
As financial pressures mount, shifting surgical cases to lower-cost settings is both a strategic and policy imperative.
“Moving cases to lower cost environments is not only strategically important, but it’s also a health policy imperative,” said Scott Kulstad, CEO of St. Paul (Minn.) Eye. “I don’t think we needed more signals to tell us of that truth, but we certainly have one.”
Wes Battiste, CEO of Destin (Fla.) Anesthesia and advisor at Avanza, sees the deal as a long-overdue jumpstart to Ascension’s outpatient strategy.
“Ascension, even admittedly so, has had very little success developing their ASC portfolio with productive ventures,” he said. “We are seeing in our advisory work at Avanza, health systems ramping up their ASC strategy. These health systems are realizing the payors, physicians, patients and politics are going to drive the volume and associated revenue to the ambulatory setting. If the health systems are not in front of this, they will surely be left behind.”
