FTC Forces Divestitures in $3.9B Ascension/AmSurg Healthcare Deal

The Federal Trade Commission (FTC) gave final approval to a consent order resolving antitrust concerns in Ascension Health Alliance’s $3.9 billion acquisition of AmSurg. The order requires Ascension to divest seven AmSurg ambulatory surgery centers across five metropolitan areas where the agency found the deal would substantially reduce competition for specific outpatient surgical services, including gastroenterology, ophthalmology, and orthopedics.

This enforcement action confirms the FTC's heightened scrutiny of healthcare consolidation at a granular level. For sophisticated counsel, it underscores that the agency's analysis is driven by local market power, not national deal size. A key feature of the settlement is a 10-year prior-notice provision, which obligates Ascension to inform the FTC of any future acquisitions of outpatient surgery centers in the affected markets, even for deals too small to trigger standard Hart-Scott-Rodino filings. This provides a long-term mechanism for agency oversight. Companies pursuing healthcare M&A, particularly serial acquisitions, should anticipate this level of service- and market-specific review and the potential for similar long-term behavioral remedies in consent decrees.