Article
The terms
Under a proposed consent order announced June 2, Ascension must divest seven AmSurg ambulatory surgery centers in Nashville, Tulsa, Waco, Wichita and Panama City, Fla. Six go to SC Affiliates, another surgery center operator. The Panama City center goes to a gastroenterology physician group that already holds a minority stake. The commission voted 2-0 and opened a 30-day public comment period before the order becomes final.
The FTC said the deal as proposed would have reduced competition for certain outpatient gastroenterology, ophthalmology and orthopedic procedures. Beyond the sales, the companies must provide transition support for up to a year, keep the divested centers viable until closing and accept a monitor. For 10 years, Ascension must give the FTC advance notice before buying surgery centers in the affected metro areas.
AmSurg operates more than 250 centers in 34 states. Ascension described the approval as a significant step toward closing.
Why it matters beyond Ascension
The order shows regulators reviewing outpatient deals procedure by procedure and market by market. A national platform acquisition can still draw a remedy if the buyer already holds strong local positions in a specialty such as gastroenterology or orthopedics. The 10-year notice requirement also limits how quickly a system can rebuild share in those markets through small tuck-in deals that might otherwise fall below federal reporting thresholds.
Board questions for growth strategy
- Where do our ambulatory surgery plans overlap with existing hospital outpatient share, specialty by specialty?
- Have we mapped local concentration before signing, rather than after regulators raise concerns?
- Do our timelines and financing assume a remedy period and a public comment window?
- If divestitures are possible, which sites could we sell without damaging referral networks or physician relationships?
Systems moving volume to lower-cost settings are right to pursue surgery centers. The antitrust review has simply caught up with that strategy, and planning for it early protects a deal’s value.
Archive entry for Jun 3, 2026, added Nov. 11, 2026.