The consolidation of physician practices and ASCs by hospitals, health systems and private equity persists in markets across the U.S. However, some ASC physicians and leaders sense a growing push towards independence as physicians fight for their autonomy and practice ownership.
As a result, a number of practice ownership and management models have emerged that view independence as a point of strength, opting out of traditional acquisition models.
Here are 13 ASC development companies and management services organizations leading the independence wave ASC and physician practice market:
Last updated Nov. 19, 2025
1. Pelto Health Partners: The group was born from a collaboration among Durham, N.C.-based Emerge Ortho, Indianapolis-based OrthoIndy and Seattle-based Proliance Surgeons. The groups all share a commitment to supporting private practice sustainability. Pelto is a platform that aims to support small to midsized independent groups, particularly those struggling with nonclinical burdens, vendor negotiations and infrastructure investments.
2. Articularis Healthcare Group: The Charleston, S.C.-based group was founded 10 years ago from a single practice and has now grown into the nation’s largest independent rheumatology practice. It boasts a “portable” model designed to work across markets, keeping collaborating physicians independent while giving the, scale and resources to grow. The group structure includes multiple practices that are linked through shared contracting, technology and operational systems.
3. ASCend: A new MSO based in Gillette, Wyo., whose mission is to keep rural ASCs independent and locally owned. Founded by CEO Linda Bedwell and COO/CFO Norberto Orellana, ASCend aims to empower physician-led surgery centers in underserved regions. ASCend also has a physician development program that physicians can complete and return to participating states, Ms. Orellana told Becker’s.
“ASCend isn’t here to criticize or judge. We say: ‘Look at what you’ve achieved with limited resources. Now let us help you go further.’ We want to help centers that are operating in ‘average’ move into ‘massive action’ and get results they couldn’t achieve alone — not from lack of effort, but because they lacked resources and expertise,” she said. “That’s who we are. That’s what we do. Any ASC out there thinking, ‘We’re surviving, but we want to do more,’—that’s where Ascend comes in. We can help them go beyond average.”
4. Capital Surgical Solutions: After witnessing the changes at a former employer when the organization was bought out by a larger company, Benjamin Stein, MD, an orthopedic surgeon, co-founded Capital Surgical Solutions. The company saw major success with its first two centers, particularly related to satisfaction and patient outcomes. The independence-focused model has also resulted in higher staff retention, a difficult feat in today’s market.
“I believe our staff value how we prioritize listening to our teams, ensuring that management decisions, such as clinical services and operating times, are made in partnership with our doctors and staff,” he said. “We’re committed to providing competitive compensation that reflects the exceptional talent we seek to attract and retain. While we manage our labor effectively, we never compromise on quality.”
5. ReKlaim Health: Founded by Dutch Rojas, also CEO and founder of Physician Capital Inc., ReKlaim seeks to build a “national coalition” of independent ASC and physician-owned hospitals through physician ownership, shared infrastructure and “union-style economics.”
“The general idea is, how do you become the all-in-one platform for business services?” he said. ReKlaim supports physician-owned practices in a number of ways, but principally by bundling risk across employee benefits, property, casualty and malpractice insurance to cut down on physicians’ insurance and benefits costs. ReKlaim helps these groups consolidate administrative workloads, including payroll, revenue-cycle management and compliance through systems that remain in physicians’ control. It also aims to strengthen practice finances through direct employer contracts and private labeled, self-funded employer plans and access to capital markets.
6. Sapient Health: Based in New York City and owned by Joseph Romano and Bill Ingram, Sapient has “the expertise of a large management company while maintaining a personalized, startup-like feel,” Mr. Romano told Becker’s. The company emphasizes regional representation, particularly in New York, New Jersey and Florida. They also operate a physician-driven model in which the firm enters deals as a minority partner, ensuring that physicians retain leadership while gaining business acumen for long-term success.
7. Redefine Management: The Matawan, N.J.-based MSO utilizes a vertically integrated model to offer a full spectrum of tailored management solutions, empowering physician groups and healthcare providers with the infrastructure they need to succeed. Redefine’s CEO William Vanderveer told Becker’s that, through the company’s partnerships with medical groups, his company is able to deliver the benefits of traditional health system alliances, like more favorable payer contracts, while preserving physician autonomy and independence.
8. CardioOne: The Houston-based, cardiology-focused MSO provides ongoing infrastructure support to its partners, specifically in IT, revenue cycle management, benefits administration, finance and credentialing through a master services agreement. CardioOne does not acquire, own or employ any of the practices it works with. Rather, it partners with groups of cardiologists, especially those who are currently employed and looking to start an independent practice, and supports them in every aspect of starting a business.
9. Atria Health: The Philadelphia-based platform is an independence-forward partnership model for cardiology practices. While Atria is backed by Cypress Ridge Partners, a private equity group, the company does not acquire practices, but rather invests in them to support long-term goals and growth. Atria recently partnered with Philadelphia-based AMS Cardiology, an independent cardiovascular practice of over 40 years, and launched an ASC through the joint venture.
10. Compass Surgical: The Raleigh, N.C.-based ASC development company has developed more than 250 ASCs in the past 30 years, and works to aligns physicians and ASCs with health systems. Compass’ goal is to preserve clinical independence while giving providers the scale and contracting power they need to compete.
“Independent physicians are really in a squeeze right now,” Mark Langston, Compass Surgical Partners’ chief development officer, told Becker’s. “If you have an independent surgery center, it’s tough. If you’re in an independent practice, also tough. If you’re doing both — good luck in today’s world — that’s really, really hard.”
11. Regent Surgical: Founded in 2001, Regent Surgical Health partners with health systems and physician groups to own, develop and manage 26 ASCs across more than 30 states. Regent holds a philosophy that partnerships should be based in mutual agreement on goals, which CEO Travis Messina argues is essential in structuring successful joint ventures and partnerships.
“If the partner can’t clearly articulate why they want an ASC or ASC network as part of their strategy, that’s a red flag,” Mr. Messina said. “Some want it because others do, without understanding why.”
12. Commons Clinic: The Los Angeles-based company aims to cut through healthcare consolidation with a venture-backed, physician-owned model that shifts surgeries to ASCs and lowers costs through bundled pricing. Commons Clinic was founded in 2021 in an effort to give private practice physicians an alternative to hospital employment or private equity acquisitions, uniting them under a physician-led model focused on transparency, cost control and patient-centered care.
“It’s basically raising money from investors to build a new kind of health system,” Prem Ramkumar, MD, medical director of technology and clinical innovation and a hip and knee surgeon at the organization, told Becker’s. “But unlike big nonprofits, we know we fail if our doctors aren’t happy. Our success depends entirely on physicians thriving, and patients having a better experience.”
13. NueHealth: With nearly 30 years of development behind it, ASC management company NueHealth has positioned itself as an agile, physician-centric organization built for the next phase of outpatient care. The company has developed, managed or owned more than 150 facilities and partnered with over 3,000 physicians and 30 health systems. A major part of its competitive edge, CEO Michael Sheerin told Becker’s, is that NueHealth has remained privately held. This structure allows leadership to invest in initiatives that may not generate immediate returns but create long-term clinical and operational value.
“Being privately held allows us to make decisions based more on long-term value than quarterly results,” he said. “A privately held company can be agile, innovative and really allows us to work with this incredibly rapidly changing healthcare market. One of the major attributes is the benefit of being privately held in our decision-making and agility.”
