Federal regulators are letting St. Louis health heavyweight Ascension move ahead with its $3.9 billion purchase of AmSurg, but only if the system unloads a cluster of ambulatory surgery centers in key cities first. It is a classic conditional approval: sell off a few assets to keep local markets competitive, and the blockbuster deal can keep marching forward.
FTC requires seven ASCs divested in five markets
The Federal Trade Commission’s proposed consent order would require Ascension to divest seven AmSurg ambulatory surgery centers in markets where the combined company could otherwise muscle out rivals: Nashville, Panama City, Florida, Tulsa, Waco and Wichita. Regulators said the transaction could weaken competition for gastroenterology, ophthalmology and orthopedic outpatient procedures in those areas, which in turn could push prices higher for patients, according to the Federal Trade Commission.
Buyers named for most centers
Six of the surgery centers are slated to go to a subsidiary of SCA Health, an ASC operator affiliated with Optum, while the Panama City site is set to be sold to Florida Gastroenterology Center. The buyers are meant to keep the centers running as independent options so patients and physicians are not stuck with a single dominant player in town. Those buyer details and the market context were reported by Healthcare Dive.
Ascension says consent order clears path to close
Ascension has told industry publications it is “pleased” with the agreement and that the FTC action allows the organization to move toward closing the AmSurg acquisition “in the near future.” The system has cast the deal as part of a broader push to bulk up its outpatient offerings and scale ambulatory care across its footprint, according to reporting from Fierce Healthcare.
Why the FTC stepped in
“Access to quality surgical care at an affordable price is critically important for millions of Americans across the country,” Daniel Guarnera, director of the FTC’s Bureau of Competition, said in the agency’s release. To back that up in this case, the proposed order requires transition assistance for up to a year, appoints a monitor to keep watch on compliance and forces Ascension to give the commission advance notice of any ASC purchases in the affected metros for 10 years. The commission voted 2 to 0 to issue the complaint and accept the consent package for public comment, according to the Federal Trade Commission.
What comes next
The proposed consent agreement is now open for a 30 day public comment period. If it is finalized, the divestitures will have to be completed under the timelines and safeguards spelled out in the order, with the appointed monitor verifying that everything goes according to plan. Industry coverage describes the FTC’s move as a conditional green light that lets the $3.9 billion transaction proceed as long as those sales close to the regulator’s satisfaction. For more on the expected timing and next steps, see reporting from Healthcare Dive.
Local stakes and the bigger picture
For Ascension’s hometown of St. Louis, the FTC’s approach preserves the system’s ability to expand outpatient services while forcing specific fixes in cities where the agency saw competitive trouble ahead. At the same time, the case highlights how federal scrutiny of health care consolidation is reshaping dealmaking across the country. Regulators are increasingly leaning on targeted divestitures to let big mergers close without hollowing out local competition, according to industry analysis by Fierce Healthcare.
