Major health systems are shedding hospitals and funneling the proceeds into ASCs.
Tenet, Ascension and Community Health Systems have collectively divested dozens of hospitals in recent years, redirecting billions toward outpatient growth.
Tenet Healthcare
Dallas-based Tenet Healthcare offers perhaps the clearest example of a health system fully committing to an ASC-first identity. In 2024, the parent company of ASC giant United Surgical Partners International sold 14 hospitals across California, South Carolina and Alabama for more than $4.8 billion, channeling the proceeds into ambulatory growth.
CEO Saum Sutaria, MD, framed the move as a turning point, describing Tenet as entering “a new era” with a growing share of performance driven by its “highly efficient ambulatory surgical business.”
Ascension
St. Louis-based Ascension is on track to become one of the largest ASC operators in the country. The system is acquiring AmSurg and its 250 ASCs for $3 billion, alongside an aggressive hospital divesture strategy. Since 2022, Ascension has shrunk its hospital footprint from 139 facilities to 90, with recent divestitures including the transfer of four Michigan hospitals to Beacon Health System in July 2025 and the sale of nine hospitals, four senior living facilities and related operations in the Chicago area to Prime Healthcare Services in June 2025.
The system’s quarterly report published May 15 described the shift: “Ascension is evolving alongside patient preferences, prioritizing the shift of select procedures to outpatient settings. The continued growth of ambulatory surgery center partnerships remains a pillar of this strategy, driving broader access to high-quality, patient-centered care.”
Community Health Systems
CHS has been executing a parallel playbook. In 2025, the company announced plans to divest seven hospitals while doubling down on ASC investment. President and CEO Kevin Hammons pointed to acquisitions of specialty practices, including robotic surgery programs, and a deliberate push to expand outpatient “access points” across key markets.
In 2026, CHS opened new surgery centers in Birmingham and Foley, Ala., and acquired a majority stake in an Anchorage, Alaska, ASC, bringing its total to 36 affiliated centers. A pending acquisition of Surgical Institute of Alabama in Vestavia, Ala., would push that number to 37. On the divestiture side, CHS has plans to sell nine hospitals across Alabama, Tennessee, Arkansas and Pennsylvania for more than $1.2 billion.
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