As high-acuity procedures continue to migrate to ASC settings, the ASC M&A landscape is reaching new highs, and health systems are moving with a level of urgency that didn’t exist even three years ago.
St. Louis-based Ascension has signed a definitive agreement to acquire AmSurg, a major ASC operator with 250 locations across the country, for $3.9 billion. This is a signal moment for the industry, with a major nonprofit making a multi-billion dollar bet on the ASC model.
At the same time, Dallas-based Tenet Healthcare, the parent company of ASC giant United Surgical Partners International, has deployed $125 million in the first quarter of 2026 to acquire seven ASCs, representing half of its $250 million annual M&A target for USPI, which now operates nearly 570 assets. USPI, SCA Health and Surgery Partners are all acquiring aggressively, and the window for mature, independently owned ASCs may not stay open forever.
As that inventory thins, Southlake, Texas-based ASC developer Solara sees a hard pivot coming toward de novo development, health system joint ventures and physician-led projects in underserved markets.
Steve Hockert, Solara’s chief development officer, joined Becker’s to discuss what the consolidation wave means for independent physicians, and why, as M&A matures, the development side of the business is becoming more relevant.
Editor’s note: This interview was edited lightly for clarity and length.
Question: What does the ASC consolidation landscape look like right now? Do you think there will be a point where the pipeline closes? If so, how will ASC development shift?
Steve Hockert: The consolidation landscape is about as active as I’ve seen in 20-plus years. You’ve got USPI, SCA Health, and Surgery Partners acquiring aggressively, and now health systems are stepping in at a level of urgency that didn’t exist even three years ago. Ascension’s move on AmSurg was a signal moment, a major nonprofit making a multi-billion dollar bet on the ASC model.
Will the pipeline close? Not completely, but it changes shape. There’s a finite number of mature, independently-owned ASCs available to acquire. As that inventory thins out, you’ll see a hard pivot toward de novo development, specifically health system JVs and physician-led projects in underserved markets. That’s Solara’s sweet spot. Our model has always been built around helping physicians maintain ownership and control, so as the consolidation wave matures, the development side of our business becomes more relevant, not less.
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.