Ascension’s bid to acquire ASC company AmSurg in June 2025 underscores the St. Louis-based health system’s broader push to expand care beyond hospital walls.
In a report outlining Ascension’s financial condition, the system said it is “strengthening its ambulatory surgery capabilities through the planned acquisition of AmSurg,” while also expanding access through investments in imaging centers and outpatient physical therapy sites.
“These strategic initiatives enhance Ascension’s overall service footprint, offering greater convenience and improved access for the communities it serves,” the report said.
The deal, valued at about $3.9 billion, is expected to be finalized after all necessary approvals are obtained, the report said.
Ascension leaders have framed the strategy as part of a larger effort to close access gaps that can drive patients to the emergency department. In a Feb. 16 LinkedIn post, President and CEO Eduardo Conrado said avoidable emergency department use among Medicaid and uninsured patients often reflects gaps in access, not patient choice.
“When primary care appointments are hard to secure, specialty referrals are delayed, medications are unaffordable or coverage is unstable, the emergency department becomes the default option,” he wrote.
To address those gaps, Ascension is strengthening partnerships with federally qualified health centers to improve primary care attachment and streamline referrals to specialty services. The system is also moving care into community clinics, virtual platforms, home-based settings and ASCs.
That shift comes as Ascension reports improved financial performance. In 2025, Ascension achieved a $2.6 billion financial turnaround in two years. Additionally, the health system reported an operating loss of $52.6 million for the three months ending Dec. 31, 2025 — a more than $91 million improvement from the $143 million operating loss reported in the same quarter the previous year.
Ascension has also restructured its footprint, divesting several hospitals and exiting select markets, assets and services. The system has reduced its hospital portfolio from about 140 hospitals three years ago to 91 wholly owned or consolidated hospitals.
“We are building a more consistent and predictable way of operating, putting people first by making care easier to access, easier to navigate and delivered in the right setting at the right time,” Mr. Conrado said in a news release.
When completed, the AmSurg transaction would expand Ascension’s ASC footprint from 58 centers to more than 300 in 34 states — a fivefold increase that would put the system in more direct competition with Tenet Healthcare’s ASC subsidiary, United Surgical Partners International. The deal, slated to close this year, would mark a significant step in how health systems participate in outpatient care.
“This transaction reflects a broader recalibration among health systems, which are increasingly recognizing the imperative to pivot more aggressively toward the ambulatory surgical setting — and away from traditional inpatient and HOPD models,” Benjamin Stein, MD, chairman and CEO of Capital Surgical Solutions, told Becker’s.
Amber Sims, Ascension’s executive vice president, chief strategy and growth officer, told Becker’s the deal will be transformational for the system.
“We really tightened our portfolio and recognized that we have to get ahead in the ambulatory business, because that’s where care is going,” Ms. Sims said during a Nov. 3 panel at Becker’s CEO and CFO Roundtable in Chicago. “It’s where patients want to receive care, where payers want to seek care, and where providers want to provide care.”
