Ascension Expands Ambulatory Surgery Reach with $3.9 Billion Amsurg Acquisition

Ascension, a major nonprofit health system, has entered into a definitive agreement to acquire Amsurg, a leading ambulatory surgery provider, in a deal valued at $3.9 billion. This strategic move significantly expands Ascension's outpatient portfolio and positions the health system to capitalize on the growing trend of care shifting from inpatient to outpatient settings.

Deal Details and Strategic Implications

The acquisition, expected to close later this year pending regulatory approval, will add more than 250 ambulatory surgery centers (ASCs) across 34 states to Ascension's network. This substantial expansion aligns with Ascension's ongoing efforts to restructure its portfolio, moving away from traditional inpatient facilities and towards more outpatient-focused care delivery models.

Eduardo Conrado, President of Ascension, emphasized the strategic rationale behind the acquisition, stating, "The shift from inpatient to outpatient care is accelerating nationwide. By investing in AMSURG's strong ASC network, we are proactively responding to this transformation."

Ascension's Portfolio Transformation

Ascension has been actively reshaping its healthcare delivery footprint in recent years:

• The health system has divested dozens of hospitals, including facilities in Illinois, Michigan, and New York.
• Despite these divestitures, Ascension still maintains a significant inpatient presence with 94 wholly owned hospitals and ownership stakes in 27 additional facilities.
• The Amsurg acquisition represents a major step in Ascension's strategy to expand its outpatient services and meet growing patient demand for convenient, community-based care.

Financial Context and Industry Trends

The Amsurg acquisition comes at a crucial time for Ascension, as the health system seeks to improve its financial performance:

• Ascension reported a $1.1 billion net loss in 2024, partly due to fallout from a cyberattack.
• In the third quarter of its 2025 fiscal year, Ascension posted a $101.2 million operating loss, compared to an $82.6 million loss in the same period the previous year.

The deal also reflects broader industry trends, as healthcare providers increasingly focus on outpatient services to reduce costs and improve patient access. Amsurg, previously owned by Envision Healthcare, has been expanding its own footprint since separating from its former parent company during Envision's bankruptcy restructuring in 2023.