Private Equity in Ambulatory Surgical Centers

The report analyzes the role of private equity in the $30 billion U.S. outpatient surgery market, highlighting a trend of 'stealth consolidation' where smaller, unreported deals bypass regulatory review. It finds that private-equity-owned ambulatory surgery centers (ASCs) often increase prices by nearly 50% within a few years without improving patient outcomes. The document identifies specific examples of consolidation involving firms like KKR, Bain Capital, and TowerBrook Capital, and calls for stronger antitrust oversight and disclosure rules to prevent rising costs and reduced healthcare choices.

• Private equity firms have become dominant in the $30 billion outpatient surgery market, where ambulatory surgery centers (ASCs) now perform over 60% of U.S. outpatient procedures. These PE-owned centers frequently increase prices by nearly 50% over a few years without any corresponding improvement in patient outcomes.
• Consolidation in the sector often occurs through 'stealth consolidation,' involving smaller, unreported deals that allow market concentration to happen before regulators can review major mergers, thereby undermining transparency and competition.
• The report identifies several high-profile consolidation strategies: KKR's $9.9 billion leveraged buyout of AmSurg (later acquired by Ascension for $3.9 billion); TowerBrook Capital and Ascension Capital's joint ventures via Regent Surgical Health with nonprofits like the Cleveland Clinic and Mass General Brigham; and Bain Capital's controlling stake in Surgery Partners, the third-largest ASC operator in the U.S.

APA

Fenne, M. (2025). Private Equity in Ambulatory Surgical Centers. Private Equity Stakeholder Project. https://pestakeholder.org/reports/private-equity-asc/

Chicago

Fenne, Michael. Private Equity in Ambulatory Surgical Centers. Private Equity Stakeholder Project, 2025. https://pestakeholder.org/reports/private-equity-asc/.

Wikipedia

{{cite report |last1=Fenne |first1=Michael |title=Private Equity in Ambulatory Surgical Centers |publisher=Private Equity Stakeholder Project |date=7 October 2025 |url=https://pestakeholder.org/reports/private-equity-asc/ |access-date=23 October 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{fenne2025private, author = {Fenne, Michael}, title = {{Private Equity in Ambulatory Surgical Centers}}, institution = {Private Equity Stakeholder Project}, year = {2025}, month = oct, url = {https://pestakeholder.org/reports/private-equity-asc/}, urldate = {2026-10-23}, note = {Indexed by Climate Insights Directory} }