Here are five major organizations selling off ASCs in 2024:

The ASC industry is historically fragmented, with approximately 68% of facilities operating independently as of 2023. However, as consolidation gains traction, industry leaders are voicing concerns about the potential negative effects on administrators, physicians and patients.

Healthcare industry consolidation has mirrored trends in other sectors — promising efficiencies and stability but often delivering reduced competition, higher costs and limited access to care. 

Healthcare giant Optum, the parent company of ASC chain SCA Health, has grown rapidly in recent years and shows no signs of slowing down.

Optum, parent company of ASC chain SCA Health, has seen massive growth, including spending $31 billion on acquisitions in the last two years.

Sioux Falls, S.D.-based Sanford Health is becoming the parent company of Black Hills Orthopedic and Spine Center, the Black Hills Surgical Hospital and the system's associated facilities in Rapid City, S.D., and Black Hills Surgery Center in Gillette, Wyo., including urgent care locations, clinics and an ASC. 

Under the Biden administration, the Federal Trade Commission took strong anti-trust positions and boosted pro-worker policies, such as a ban on noncompete agreements. 

United Surgical Partners International, Surgery Partners and HCA Healthcare, through its Surgery Ventures arm, are three of the largest ASC operators by number of centers. 

Former independent practice Hillsdale (Mich.) Medical Associates is now owned and operated by Hillsdale Hospital, Hillsdale Daily News reported Nov. 13. 

Bradenton, Fla.-based MCR Health, a nonprofit medical group, sought Chapter 11 protection Nov. 11, the Tampa Bay Business Journal reported Nov. 13. 

Dallas-based Steward Health Care has been facing financial difficulties and controversies since it sought Chapter 11 bankruptcy protection May 6.

Downers Grove, Ill.-based Duly Health and Care has launched a strategic partnership with ASC management services organization Surgery Partners.

The U.S. Justice Department has filed a lawsuit against UnitedHealth Group, parent company of Optum, to prevent its planned $3.3 billion acquisition of home health provider Amedisys, Bloomberg reported Nov. 12.

A medical office building in El Paso, Texas, has sold for $7.1 million, according to a Nov. 12 report from REBusiness Online.

Retail giant Amazon continues to expand into healthcare, including partnerships with several health systems through its hybrid primary care company One Medical. 

Brentwood, Tenn.-based ASC chain Surgery Partners posted adjusted earnings per share of $0.19 for the quarter, missing Wall Street's expectation of $0.25, according to third-quarter earnings released Nov. 12. 

Hospital and ASC partnerships have been on the rise in 2024, but these joint ventures are not always an ideal match for ASCs looking to grow while maintaining autonomy in competitive markets. 

Physicians Surgery Center of Jackson, Tenn., has sold a majority of its shares to a nationally recognized ASC management firm.

ASCs, hospitals, health systems and investment groups have increasingly looked to joint venture partnerships over the past year as a strategy for growing practices and expanding access to care.

While ASCs remain largely independent, consolidation is on the rise as the industry's largest chains continue to expand, leaving the state of practice independence in flux.