Dive Brief:
- The Federal Trade Commission is compelling Ascension to sell several surgery centers in order for the nonprofit giant to close its $3.9 billion acquisition of ambulatory surgery provider AmSurg.
- The FTC’s proposed consent order released Tuesday requires Ascension to divest seven AmSurg facilities in markets where the combination would otherwise threaten competition for ambulatory surgery services, regulators said.
- Ascension said it was pleased with the compromise, which should allow the AmSurg acquisition to close “in the near future.”
Dive Insight:
Ascension agreed to acquire AmSurg one year ago as part of the Catholic health system’s larger push to reorient its hospital-heavy portfolio more towards outpatient care.
The AmSurg deal will add more than 250 ambulatory surgery centers across 34 states to Ascension’s portfolio, bringing the operator’s total to more than 300 centers in 35 states.
Ascension originally expected the acquisition to close last year. But it has yet to cross the finish line, held up by regulatory review.
Ascension snapping up AmSurg raises distinct concerns, according to the FTC. Both companies provide outpatient surgical services, ranging from cataract surgeries to colonoscopies, in overlapping markets. Allowing the combination could lead to higher prices for patients and result in other anticompetitive outcomes, like reducing innovation in surgical services, regulators said.
However, the proposed sales in the markets in question — Nashville, Tenn.; Panama City, Fla.; Tulsa, Okla.; Waco, Texas; and Wichita, Kan. — would ameliorate those concerns, according to the FTC.
“Access to quality surgical care at an affordable price is critically important for millions of Americans across the country,” Daniel Guarnera, the director of the FTC’s Bureau of Competition, said in a statement. “The FTC’s action ordering divestitures of surgical care centers will help preserve a competitive market that will allow patients to get the care they need at a fair price.”
Six of the seven centers are set to be sold to a subsidiary of SCA Health, one of the largest ambulatory surgery center networks in the U.S. SCA Health is owned by UnitedHealth’s Optum.
The seventh center in Panama City will be divested to Florida Gastroenterology Center, a physician group that currently owns a minority stake in the relevant facility, according to the proposed consent agreement.
The order would appoint a monitor to ensure Ascension and AmSurg are complying with their obligations under the sales, including keeping the divested facilities operational until they change hands and not poaching employees from sold locations.
It would also require Ascension to notify the FTC if it purchases any other ambulatory surgery centers in the designated metro areas over the next decade.
The public has 30 days to comment on the proposed order. However, the compromise amounts to a preliminary approval of the deal by the FTC — a positive development for Ascension, which is acquiring AmSurg as part of its efforts to achieve a financial turnaround.
Health systems continue to struggle with shaky patient volumes and spiking costs hitting hospitals, all while rising demand for convenient and inexpensive access to care pushes more consumers to outpatient locations.
Despite some recent signs of improvement, Ascension has experienced ongoing operating losses in recent years, along with financial fallout from a massive cyberattack in 2024.
Executives are banking that onboarding AmSurg will allow Ascension to expand its offerings in the growing outpatient market, and adapt to the broader shift from inpatient to outpatient care.
AmSurg was previously owned by physician staffing firm Envision Healthcare, but was split off from the company during Envision’s bankruptcy restructuring in 2023.
AmSurg is currently a subsidiary of Ambulatory Topco LLC, a holding company formed following Envision’s bankruptcy to serve as AmSurg’s parent.
