Becker's ASC Review

21 TRANSACTIONS A new era of ASC consolidation efforts By Cameron Cortigiano W ith nearly 2,000 ASCs under a partnership by a national operator, up from about 1,300 centers in 2011, the consolidation of ASCs has taken on a new path over the past decade and a half. According to VMG Health's 2025 M&A report, valuation multiples in the ASC space have stabilized around eight times operating income, signaling that the industry is maturing and building up merger and acquisition competition. e emergence of private equity over the past few years has changed the way the ASC industry operates. While not at the 2022 peak of 424 private equity-backed healthcare deals, private equity firms were involved in nearly 300 physician medical group transactions in 2024. As consolidation and M&A continue, smaller physician groups and facilities are likely to have a tougher time keeping up. at is something that Gregory Brennan, MD, a gastroenterologist based in Mansfield, Texas, has seen over the past few years in Texas. "In the last one to two years in the Dallas-Fort Worth area there have been several physician transactions with both primary care and specialty groups," Dr. Brennan told Becker's. "I have seen both the formation of large multispecialty groups and the splinting off of others. I have definitely seen a trend in more primary care and internal medicine practices joining hospital groups or changing hands. I think in general it is harder for smaller practices to keep up with consolidation and remain independent." To adapt, independent ASCs are exploring strategic partnerships as opposed to a straight up sale, allowing them to retain some level of control and autonomy. In a survey from VMG Health, 59% of independent ASCs would consider a strategic partnership. Working with a health system was significantly preferred compared to teaming up with a management company or private equity group. e potential consequences for this increased PE activity for physicians are real, according to Marc Greenberg, MD, an orthopedic surgeon based in Baltimore. "I think it's probably the worst for physicians. As you lose choice, the ability of physicians to feel like they can leave and go somewhere else goes down," Dr. Greenberg told Becker's. "Employers take advantage of that. I think they'll be stuck in worse jobs, and overall, pay will go down." n Pelto launches ASC ownership platform, drives $1.2M in annual physician savings By Patsy Newitt P hysician-owned Pelto Health Partners has launched an ASC platform initiative, expanding its vendor ecosystem to include resources for ASC development and management, according to a Feb. 25 press release. The initiative is designed to allow physicians to navigate the complex and capital-intensive process of opening and owning an ASC. It adds a channel partnership arm focused on ASC development, group purchasing, capital equipment planning and financing, and operational management. Across two member practices operating individual and joint venture ASCs, the program has delivered more than $1.2 million in annual savings, according to the release. The returns flow directly back to physicians without compromising ownership or operational control. The move builds on Pelto's existing resources, which include group purchasing, contract optimization, revenue cycle support and strategic advisory services. "In the first three years of PELTO, we've been able to isolate where independent practices lose the most ground — and accelerate their path back to viability," Rachel Uzlik, Pelto's fractional CEO, said in the release. "We've done that through collective infrastructure, negotiated contracts, and the shared intelligence of a physician-led network. The ASC Platform Initiative is the natural next step: taking everything we've built and applying it directly to surgery center development through a curated network of channel partners who understand what independent medicine actually needs." Minneapolis-based Pelto Health Partners was launched three years ago as a collaborative effort between three physician-owned orthopedic groups — EmergeOrtho, OrthoIndy and Proliance Surgeons — to preserve private practice autonomy and support long-term sustainability. n

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