Becker's ASC Review

36 TRANSACTIONS that corporate acquisitions oen come at the expense of clinician decision-making. "e continued acquisition of medical practices by large corporations, whose focus is on profits and Wall Street, will continue to have a chilling effect on clinicians and ultimately, patients," he said. Surveys reflect these concerns. A 2023 NORC survey from the University of Chicago found that 61% of employed physicians reported moderate or no autonomy to make referrals outside their system. Nearly half (47%) said they adjust treatment options to reduce costs based on practice policies or incentives. Benjamin Levy III, MD, gastroenterologist at University of Chicago Medicine, reinforced the dual edge of consolidation. "Optum's acquisition of U.S. Digestive Health is important because it's an example of how companies … can quickly consolidate gastroenterology practices and integrate care within a health insurance ecosystem," he said. "Unfortunately, physicians might lose some autonomy during the acquisition." Concerns also extend to the cost of care. A study from the National Bureau of Economic Research found that physician practices acquired by hospitals between 2008 and 2016 experienced a 15.1% price increase for physician services within two years of acquisition, with no measurable quality improvement. "We have to anticipate that the cost of care will increase as market power is consolidated to those that control the care and the dollar," Andrew Lovewell, CEO of Columbia (Mo.) Orthopaedic Group, told Becker's. On the policy front, President Donald Trump's Aug. 13 repeal of Executive Order 14036 — a Biden-era directive scrutinizing consolidation across industries, including healthcare — could accelerate deals. While federal antitrust laws remain, the repeal removes one layer of oversight, giving health systems and consolidators more leeway to pursue mergers. At the state level, however, regulators are tightening scrutiny. In 2025, Oregon enacted the country's strictest limits on corporate and private equity ownership of medical groups, requiring physicians to retain majority control. Pennsylvania expanded its attorney general's authority to review and potentially block healthcare M&A. For independent, physician-led groups, consolidation raises both challenges and opportunities. "Consolidation can bring resources, scale and leverage, but it also risks diminishing the physician's voice and shiing the focus away from patient-centered care toward purely financial outcomes," said Dr. Geogy Vennikandam, COO of GI Partners of Illinois. In markets like Dallas-Fort Worth, gastroenterologists are already feeling the pressure. Gregory Brennan, MD, a gastroenterologist in Mansfield, Texas, told Becker's. "In the last one to two years … there have been several physician transactions with both primary care and specialty groups," he said. "I think in general it is harder for smaller practices to keep up with consolidation and remain independent." Optum's expansion in GI coincides with another blockbuster ASC transaction: Ascension's $3.9 billion agreement to acquire AmSurg, which will boost its ASC portfolio from 58 to more than 300 centers nationwide. Between payer-backed consolidators like Optum and health system- driven expansions like Ascension's AmSurg deal, the ASC industry is entering a new phase. Scale, integration and financial leverage are shaping where procedures take place and the owners of those providing care. n Walgreens goes private, splits into 5 companies in $10B deal By Patsy Newitt Walgreens Boots Alliance has officially transitioned to private ownership following its acquisition by New York City–based private equity firm Sycamore Partners. Here are five things to know: 1. Shareholders approved the $10 billion sale at a special meeting July 11. They received $11.45 per share in cash, about $9.9 billion in total based on 865 million outstanding shares. An additional payout of up to $3 per share could follow from Walgreens' stake in VillageMD, potentially raising the deal's overall value to $23.7 billion. 2. Under Sycamore's ownership, Walgreens Boots Alliance will operate as five independent businesses: Walgreens, The Boots Group, Shields Health Solutions, CareCentrix and VillageMD. 3. Walgreens began considering a sale in December after unveiling plans to shutter roughly 1,200 stores over three years, including 500 in fiscal 2025. Leadership has said that private ownership offers more flexibility to pursue a turnaround strategy and strengthen its pharmacy, retail and healthcare services portfolio. 4. Mike Motz was appointed CEO effective Aug. 28, succeeding Tim Wentworth, who remains on the board. John Lederer, a former Walgreens director and Sycamore senior advisor, has been named executive chairman. 5. The company will keep its name and Chicago headquarters. Executives stressed that while Sycamore's investment provides room to maneuver, the turnaround will require patience, focus and steady reinvestment to adapt to an evolving healthcare and retail landscape. n

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