The ASC market is reentering a phase of aggressive private equity activity as capital flow resumes and buyers target scale in strategic geographies.
In just the past six months, multiple PE-linked ASC moves have been tracked, including Great Hill Partners’ acquisition of The Woodlands, Texas-based Blue Cloud Pediatric Surgery Centers and Olympus Partners-backed EyeSouth’s purchase of Bingham Farms, Mich.-based Sunvera Group.
Physician practice activity is also fueling momentum. After a quieter period, investment in physician groups is expected to expand in 2025, creating more opportunities for ASC deals tied to those practices. The sector remains highly fragmented — with about 67% of ASCs independently owned as of 2024 — but consolidation by health systems, private equity firms and national operators is reshaping the competitive landscape.
Leaders say physician alignment will be decisive in the next wave of deals.
“The value has shoes — it can walk out the door anytime,” Andrew Carlson, director of growth and strategy at New York-based Growth Orthopedics, told Becker’s, noting the risk of losing physicians when their clinical input is not prioritized.
Others emphasized that ensuring younger physicians have equity and a voice in governance is just as critical to maintaining long-term engagement
Large-scale deals are already setting the tone for what may follow. Ascension’s pending $3.9 billion acquisition of AmSurg would expand its ASC portfolio from 58 to more than 300 centers in 34 states — a transaction many view as a turning point in ASC consolidation.
Meanwhile, Brentwood, Tenn.-based Surgery Partners recently rejected a takeover bid from Bain Capital, highlighting both the sector’s growing attractiveness and the complexity of striking the right deals.
Critics are questioning how far consolidation can go. Baltimore-based orthopedic surgeon Marc Greenberg, MD, told Becker’s that private equity may eventually run out of surgeons who can be profitable in an ASC, adding that the challenge of standardizing hundreds of centers across the country raises doubts about long-term sustainability
With private equity poised to remain active, the next wave of ASC deals will likely combine platform consolidation with targeted recapitalizations. Success may hinge less on capital alone and more on careful physician alignment, service line strategy and operational discipline that can sustain long-term growth.
