The ASC megamergers that shaped the industry

The ASC industry went through a series of megamergers between 2015 and 2018 which reshaped the industry, according to VMG Health's 2024 Healthcare M&A Report published May 7. 

Here are five notes to know about the mergers:

1. In 2015, Tenet Healthcare purchased 50.1% of Dallas-based United Surgical Partners International for $425 million. 

USPI has since grown to the largest ASC chain in the country. In 2020, Tenet acquired more than 90 ASCs from SurgCenter Development for approximately $1.2 billion, paving the way for USPI to market dominance. As of the end of the first quarter, USPI has interest in 512 ASCs and 25 surgical hospitals spanning 38 states.

2. In 2016, AmSurg and Envision Healthcare Holdings signed a definitive merger agreement.

In May 2023, Envision filed for Chapter 11 bankruptcy. Amsurg, which comprises 2,000 physicians and 250 surgery centers across 34 states, split from the company in October and purchased all of its ASCs. 

3. In 2017, Deerfield, Ill.-based SCA Health, then known as Surgical Care Affiliates, was acquired by Optum. The company has grown from 186 ASCs in 2019 to 320 in 2023. 

While the company shed several ASCs in deals inked this year, SCA Health acquired at least two cardiovascular providers in 2023 — National Cardiovascular Partners, which comprises 21 cardiac catheterization and vascular labs, and Ponte Vedra Beach, Fla.-based Pivotal Healthcare, which has 11 affiliate practices and 14 locations.

Optum, the country's largest employer of physicians, has spent $31 billion on acquisitions in the last two years

4. Also in 2017, National Surgical Healthcare was acquired by Nashville-based Surgery Partners, and Bain Capital acquired a controlling equity interest in Surgery Partners. 

Surgery Partners, the only publicly traded ASC company remaining, has 192 affiliated practices nationwide, and continues to be a major player in the ASC industry.

5. Additionally, private equity firm KKR acquired two ASC operators in this time period, according to the VMG report, as well as Nashville-based Covenant Surgical Partners, which operates ASCs and physician practices. 

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