Ascension Completes $3.9 Bn AmSurg Acquisition After FTC Approval

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The transaction, first announced in June 2025, positions Ascension as the third-largest ambulatory surgery center (ASC) platform in the United States, with a network exceeding 300 centers nationwide.

Ascension has completed its $3.9 billion acquisition of ambulatory surgery management company AmSurg, days after receiving approval from the Federal Trade Commission (FTC) under conditions designed to preserve competition in several local markets.

The transaction, first announced in June 2025, positions Ascension as the third-largest ambulatory surgery center (ASC) platform in the United States, with a network exceeding 300 centers nationwide.

The FTC cleared the acquisition through a proposed consent order requiring Ascension to divest seven ambulatory surgery centers in markets where regulators determined the deal could reduce competition. The affected facilities are located in Panama City, Florida; Tulsa, Oklahoma; Waco, Texas; Wichita, Kansas; and Nashville, Tennessee, where two centers were included.

Under the agreement, six of the centers will be transferred to national ASC operator SC Affiliates, while the Panama City facility will be acquired by Florida Gastroenterology Center, a physician group that already held a minority ownership stake in the site.

Before the acquisition, AmSurg operated more than 250 ambulatory surgery centers across 34 states. The FTC said Ascension’s ownership of the seven divested facilities could have reduced competition for outpatient gastroenterology, ophthalmology, and orthopedic procedures in those markets, potentially resulting in higher costs and diminished patient choice.

In addition to the divestitures, the FTC order requires the companies to provide up to one year of transition assistance to the transferred facilities and prohibits interference with employee relationships at those centers. Ascension must also notify the FTC in advance of any future ASC acquisitions in the metropolitan areas surrounding the divested locations for the next 10 years.

Ascension has described the acquisition as part of its broader strategy to expand care delivery outside traditional hospital settings. The nonprofit health system has reported continued growth in outpatient surgery volumes and has increasingly focused on ambulatory care services.

According to Ascension, the acquisition strengthens its presence in 10 existing markets while providing entry into 25 additional markets through AmSurg’s network. The expansion is expected to increase outpatient surgical capacity while allowing Ascension hospitals to focus on higher-acuity and more complex inpatient care.

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