The dynamics shaping mergers and acquisitions within the ASC space are constantly shifting as corporate entities push consolidation efforts and independent practices seek new ways to partner and scale their operations.
Two leaders in the ASC space recently joined Becker’s to share their predictions for how M&A in the ASC space will change in 2026.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What M&A trends do you think will have the most impact on the ASC market in 2026?
Rhett Barker. CEO of AlloDirect: I think the most consequential trend is that acquirers are now prioritizing supply-chain sophistication and vendor economics as a core part of deal underwriting. For years, ASC M&A was about [operating room] capacity and case mix. Now, it’s also about who has clean vendor files, standardized implant formularies and real visibility into true episode-of-care cost. That’s shifting how platforms evaluate acquisition targets and how management teams prepare for a transaction.
A second dynamic is the continued consolidation on the customer side driving parallel consolidation on the supply side. As orthopedic and [musculoskeletal] platforms scale, they’re demanding enterprise-grade solutions from suppliers instead of fragmented, regional approaches. That’s accelerating both vertical integration among larger distributors and innovation among smaller, tech-forward vendors trying to offer better transparency and lower cost structures.
The third thing I’d watch is the quiet but real shift away from [group purchasing organization]-centric sole-sourcing toward more transparent, market-based procurement models. As the [Federal Trade Commission] scrutinizes distribution economics and payers demand cost justification, health systems and ASC platforms are exploring alternatives that remove redundant layers and provide real-time visibility. It’s still early, but it’s a meaningful tailwind for any vendor playing in that space.
Joe White. CEO and Founder of Sendit Healthcare (Nashville, Tenn.): In 2026, the most impactful ASC M&A won’t be about adding square footage, it’ll be about controlling flow and economics. We’re seeing continued consolidation around platforms that can align physicians, sites of care and reimbursement under one operating model. That’s happening because outpatient volume keeps growing and case acuity is rising, pushing ASCs from “low-cost alternative” to strategic core assets.
The deals that matter most will prioritize physician alignment, data infrastructure, and reimbursement capabilities over pure geographic expansion. Buyers are asking, “Can this center reliably move cases through the system and get paid efficiently?” If the answer is no, scale alone won’t save it.
