Seven ASC leaders were asked what ASC competition will look like in five years. This is how they responded:

IRA Capital, a private equity firm, has acquired two medical office buildings in Vista, Calif., predominantly occupied by San Diego-based Scripps Health.

WellSpan Health has acquired an ownership stake in Hagerstown, Md.-based Parkway Surgery Center, the health system said July 19. 

Seven ASC leaders spoke with Becker's to discuss how competition in the ASC industry has shifted in the last five years. 

Two medical office buildings in Waterloo, Iowa, have been sold for $16.4 million, ReBusiness Online reported July 18. 

Medical property deals have accounted for more than $133 million in the last 30 days, including $84.5 million in Florida and  $26.6 million in North Carolina.

Florida is one of the most active states for medical real estate. Four Florida medical office building transactions in the last 30 days:

A medical office building in Youngstown, Ohio, was sold to a California investor for $2.3 million July 12, The Business Journal reported.

The 142 physician group mergers and acquisitions in this year's second quarter outpaced those of the first quarter by 5 percent, according to data in the "Healthcare M&A Report" published July 13 by healthcare analyst LevinPro HC. 

Healthcare developer Anchor Health Properties bought a medical office building in Marietta, Ga.

Real estate company NAI James E. Hanson facilitated two medical office building lease transactions in New Jersey, NJBiz reported July 11. 

Independent physician services company Versant Diagnostics has acquired Elgin (Ill.) Laboratory Physicians and Pathology Consultants of Chicago, Daily Herald reported July 11. 

Healthcare Realty Trust is currently under contract with five parties to sell or enter into joint ventures for 27 medical properties nationwide totaling $807 million, Commercial Search reported July 11.

Vantage Commercial has sold a five-building medical complex in Hammonton, N.J., ROI-NJ reported July 11. 

Central Peninsula Hospital in Soldotna, Alaska, is buying an independently owned ASC — Surgery Center of Kenai — for nearly $10 million, radio station KDLL reported July 8.

Robotics Outpatient Center Los Angeles and Prime Healthcare have inked a deal to expand both groups' outpatient surgery offerings, the Ontario, Calif.-based health system said July 8.

A medical office building in Brandon, Fla., was sold for $39 million, Business Observer Florida reported July 5. 

Outpatient investments are heating up, with many companies looking to ASC chains, physician groups and outpatient properties for financial growth. 

Here are the biggest deals in the second quarter of 2022 that ASC leaders need to know:

Physician medical group deals nearly doubled in the first quarter of 2021 and have continued at the same elevated levels since, according to a June report from PwC.