The ASC industry was shaped by a series of "mega-mergers" made between 2015 and 2018, according to VMG Health's "Annual Healthcare M&A Report 2022."
In 2015, Dallas-based Tenet Healthcare and ASC chain United Surgical Partners International merged, followed by Envision Healthcare Holdings and ASC chain AmSurg in 2016. The following year, SCA Health, formerly Surgical Care Affiliates, was acquired by UnitedHealth Group subsidiary Optum, and National Surgical Healthcare was acquired by Surgery Partners.
These mega-mergers, which VMG Health described as "transactions that unite two large corporations valued at billions or more," have shaped the increasingly consolidated ASC industry.
Consolidation was also accelerated by private equity interest — KKR acquired two ASC operators as well as Nashville, Tenn.-based Covenant Surgical Partners between 2015 and 2018, according to the report. In 2018, KKR also acquired Envision and AmSurg. Only Surgery Partners remains as a stand-alone publicly traded ASC chain.
These mega-mergers cleared the way for subsequent deals in recent years, with Tenet and USPI leading the charge with both transactions and number of ASCs.
In 2020, USPI acquired 45 ASCs from Towson, Md.-based SurgCenter Development for $1.1 billion. The following year, it acquired nine ASCs from Compass Surgical Partners for $78 million.
The industry will likely continue to consolidate. Tenet executives laid plans to grow USPI to acquire or develop more than 150 ASCs over the next three years to exceed 600 ASCs in its portfolio by the end of 2025. Additionally, SCA Health, Surgery Partners and AmSurg have also been adding ASCs and health system partnerships.