After a period of selling hospitals, Ascension is back buying again, and its latest deals show exactly where the money is going: surgery centers, fast-growing suburbs and care delivery, not insurance.
The newest move came Oct. 1, when Austin, Texas-based Ascension Seton signed a definitive agreement to acquire three care sites in the north Austin area from Cedar Park, Texas-based Family Hospital Systems. The deal includes Family Hospital at Lake Travis, which provides 24/7 emergency and inpatient care, plus two urgent care, primary care and imaging sites in Cedar Park and Round Rock.
“Austin and its surrounding suburbs are among the fastest-growing communities in the nation, and our healthcare services need to expand to match that growth,” Jamie Youssef, ministry market CEO of Ascension Texas, said. “Adding these neighborhood locations to Ascension Seton brings our care teams where they are needed most, ready to provide immediate support and connect patients to specialized care.”
Financial terms of the deal — which is expected to close later this year — were not disclosed.
It is St. Louis-based Ascension’s third notable acquisition in about 16 months. It also arrives weeks after the 91-hospital system reported that its core operations generated an operating profit in fiscal 2026 — a substantial turnaround from the $3 billion operating loss reported in fiscal 2023.
As of June 2025, Ascension had sold or consolidated about 35 hospitals over the previous 16 months. Deals included the sale of Ascension St. Vincent’s Health System in Birmingham, Ala., to the University of Alabama System for about $450 million, eight Illinois hospitals to Ontario, Calif.-based Prime Healthcare for $375 million and a joint venture that folded 8 southeast Michigan hospital campuses under the Henry Ford Health brand.
The system lost $491 million from operations in fiscal 2025. A year later, the picture had shifted.
For the fiscal year ending June 30, 2026, Ascension narrowed its operating loss by $371 million, to $120 million. Excluding interest on bonds issued ahead of the Amsurg deal and related transaction costs, core operations generated $109 million in operating income. Recurring operating EBIDA rose $388 million to $1.2 billion, a 5% margin.
Total revenue slipped to $24.5 billion from $25.3 billion. On a same-facility basis, which strips out divested hospitals, operating revenue rose 9.8% to $24.1 billion. Ascension ended the year with $15.1 billion in unrestricted cash and investments and 233 days cash on hand.
Eduardo Conrado, Ascension’s president and CEO, tied those gains directly to expansion.
“Our teams are bringing preventive care closer to home, increasing access to primary and specialty care and helping people access affordable medications. We are also opening and expanding sites of care so patients can get the right care in the right setting,” Mr. Conrado said. “That is why financial performance matters.”
Saurabh Tripathi, executive vice president and CFO, attributed the financial turnaround to the “relentless incrementalism” mindset that has helped drive improved volume and operating performance.
“Every day you come in, focus on a small, tiny improvement on a consistent basis, whether it’s volume, cost, efficiency, length of stay — all the key metrics,” Mr. Tripathi told Becker’s. “That relentless incrementalism is paying off, and that’s what we are seeing in our financial results.”
However, Ascension’s buying reignited before the books fully recovered.
In June 2025, Ascension Seton acquired full ownership of 126-bed Cedar Park (Texas) Medical Center for $436 million in cash, buying out Franklin, Tenn.-based Community Health Systems’ 80% stake. The Family Hospital Systems deal adds to that same Central Texas footprint, where Ascension Seton operates 12 hospitals and more than 200 care sites, according to its website.
Ascension’s biggest move came in June, when it completed its acquisition of Nashville, Tenn.-based Amsurg in a deal valued at about $3.9 billion. Amsurg operates more than 250 ambulatory surgery centers across 34 states, and the deal expanded Ascension’s ambulatory platform to more than 300 ASCs.
“We see [Amsurg] as a major accelerant to build more hub and spoke around our existing hospital system network in our nine markets,” Thomas Aloia, MD, executive vice president and chief clinical officer at Ascension, told Becker’s. “I really think these should be called APCs — ambulatory procedural centers. The idea that these are surgery-only is a thing of the past. That framing opens the art of the possible for eye, GI, and other procedures, but also interventional radiology and cardiac cath: things we see as procedural but not necessarily surgical.”
As it expands care delivery, Ascension is pulling capital out of health plans.
Earlier this month, the health system agreed to sell its stake in Arizona Medicaid managed care plan Mercy Care to Aetna. San Francisco-based Dignity Health, part of Chicago-based CommonSpirit, is also selling its stake.
Ascension expects the sale to free up at least $1 billion for the two systems combined, which both plan to redeploy into provider operations.
“The insurance part is probably not our core strength,” Mr. Tripathi told Becker’s. “From a core strategy perspective, Mercy Care didn’t fit really well with Ascension or CommonSpirit, and it was a strategic move for both of us to give this ownership to someone who knows the health plan really well, Aetna.”
The deal extends a steady retreat from the insurance business.
Ascension sold its 50% stake in Network Health to Froedtert Health in November 2023, exited ACA marketplace coverage in Texas, Indiana, Kansas and Tennessee in 2025, and the system no longer holds a stake in Wellcare Complete — its former Medicare Advantage venture with Centene.
Ascension’s remaining insurance exposure is indirect, through a 20% stake tied to its Michigan joint venture with Detroit-based Henry Ford Health, which owns Health Alliance Plan, a spokesperson for the system confirmed to Becker’s.
The Mercy Care sale is expected to close in fiscal 2027, pending regulatory approval. The deal would free up more capital for Ascension to pursue its revamped growth strategy: expanding outpatient care and investing selectively in high-growth markets, rather than rebuilding the hospital footprint it spent years shrinking.
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