Dive Brief:

• Tenet Healthcare’s ambulatory unit United Surgical Partners International has partnered with United Urology Group, a network of urology affiliate practices, to jointly operate 22 ambulatory surgery centers, as Tenet continues to double down on its ambulatory strategy.
• Under the terms of the deal, USPI will acquire a portion of UUG’s ownership stake in new and established facilities in Maryland, Colorado and Arizona. Tenet did not respond to questions about the deal’s financial terms by the time of publication.
• Adding UUG and its affiliated ASCs will complement USPI’s growing urology service line and expand its partnership network by adding more than 140 urology physicians, according to the company. Meanwhile, partnering with USPI, which operates the largest ambulatory platform in the U.S., will help UUG accelerate the delivery of ASCs in new markets.

Dive Insight:

As more services migrate to outpatient care settings, Tenet has been betting big on its ambulatory services business to drive future revenue. The Dallas-based hospital operator has spent more than $2.5 billion in capital investment to scale USPI since December 2020, CEO Saum Sutaria told investors on a February earnings call.

That buying spree included a $1.1 billion acquisition of SurgCenter Development which was finalized in December. Along with the roughly 130 surgery centers that Tenet got a stake in through that (and another prior) deal, the system also plans to purchase 30 more facilities from SurgCenter this year.

As a result, Tenet’s ASC portfolio has swelled to become much larger than the number of hospitals it operates as the system pursues margin and multiple expansion. Its ambulatory earnings, which helped drive Tenet’s net income up 26% year-over-year in the first quarter even as hospital revenue slipped, are expected to represent roughly half of Tenet’s overall profits by the end of 2023.

USPI has more than 440 locations across the U.S. The new partnership with UUG will add urology centers within USPI’s existing markets, USPI CEO Brett Brodnax said in a Tuesday release on the deal.

The transaction is expected to close in the third quarter, subject to regulatory approvals and closing conditions.

On completion, USPI will manage and jointly own the centers with UUG and its affiliated practices. The centers will be consolidated in Tenet’s financial statements, the system said.

There is further room to scale the deal. UUG, which was formed in 2016, has 95 offices and ambulatory surgery centers active in five states. Along with Maryland, Colorado and Arizona, UUG also has offices in Delaware and Tennessee.

UUG is currently owned by Audax Private Equity, a PE firm that focuses on middle-market companies across a range of industries, including healthcare.