The Ambulatory Care Boom: Why Investors Are Fighting for a Slice
If you’ve been wondering where the next wave of healthcare deals is headed, some may just be taking place between the dry cleaner and the Subway shop. The future of medicine isn’t happening in those gleaming hospital towers anymore. It’s unfolding in modest ambulatory care companies and neighborhood physical therapy clinics that are quietly flipping how Americans receive medical care. Some can be found in your local strip mall, others in sleek medical office buildings, but all are part of a shift that’s catching the attention of dealmakers everywhere.
The numbers tell a compelling story. The U.S. ambulatory surgical centers market size, according to a report by Fortune Business Insights, was valued at $45.69 billion in 2024. The market is projected to grow from $46.83 billion in 2025 to $62.03 billion by 2032, exhibiting a compound annual growth rate of 4.1% during the forecast period. Meanwhile, the U.S. physical and occupational therapy industry was worth $53 billion in 2024, up 6.4% from 2023.
But apart from the market size, the real story is about a fundamental shift in how healthcare gets delivered, and why private equity (PE) firms from Welsh Carson to Great Hill Partners are scrambling to get a piece of the action.
Great Migration Out of Hospitals
The migration from expensive hospital settings to outpatient facilities represents one of the most significant structural changes in healthcare delivery. As noted by CliftonLarsonAllen, an increasing number of patients are seeking care in outpatient settings such as ambulatory surgery centers due to their affordability and shorter wait times. More private equity investors will turn their attention to surgery centers, with more hospitals investing in ambulatory care centers, too. And because the U.S. health system is seeking to move care into more cost-effective models, the list of approved procedures for ambulatory care centers will likely continue to expand.
Procedures that once required overnight hospital stays can now be completed in a few hours at a fraction of the cost. For dealmakers, this represents a rare combination of lower costs, better patient satisfaction, and predictable revenue streams.
A search on Finder, our deal search and discovery tool, reveals the range of opportunities available across different scales and specializations among the market leaders.
The Big Four In Ambulatory Care
The Dallas-based giant represents the scaled consolidator model that private equity loves. With revenue ranging from $500 million to $1 billion and over 10,000 employees, USPI has been on an acquisition spree, scooping up SurgCenter Development for $1.1 billion in 2021. Founded in 1998, the company owns and manages ambulatory surgical facilities, operating short-stay surgical facilities licensed as ambulatory surgery centers, specialty hospitals, and hospitals.
Now under KKR’s ownership, Nashville-based AmSurg operates both ambulatory surgery centers and provides outsourced physician services across multiple specialties including anesthesiology, children’s services, emergency medicine, and radiology. With over 10,000 employees, AmSurg represents the kind of scaled platform that acquires, develops, and operates ambulatory surgery centers in partnership with physician practice groups throughout the U.S.
This physician-owned facility shows how smaller, specialized players can carve out profitable niches. With 11-50 employees, Roanoke focuses on ear, nose, throat, orthopedic surgery, ankle and foot surgery, and pain management. The center’s mission centers on providing a convenient, safe, and cost-effective alternative to inpatient surgery and hospital outpatient surgery.
Even micro-operations demonstrate the sector’s accessibility for entrepreneurial physicians. With just 1-10 employees, Avicenna provides ear, nose, throat, podiatry, urology, orthopedic, gastroenterology, and spine surgery services, proving that specialized outpatient surgical centers can thrive at virtually any scale.
Physical Therapy Investments
While ambulatory surgery centers grab headlines, physical therapy investments represent the steady performer in the outpatient portfolio. Private equity firms have shown increasing interest in the physical therapy (PT) sector, investing in both individual practices and larger multi-site organizations.
The recent acquisition of WestStar Physical Therapy Network by Accord Asset Partners and Paras Capital Partners illustrates the appeal. WestStar’s specialization in workers’ compensation and auto injury patients provides predictable, insurance-backed revenue streams that private equity firms find attractive. This deal follows a pattern of consolidation that’s reshaping the industry.
As reported by Towards Healthcare, the physical therapy market will likely exceed $28 billion by 2024. Valuation is projected to hit $41 billion by 2034. What makes these projections particularly compelling is the demographic boost. An aging population means more joint replacements, more rehabilitation needs, and more consistent demand for services.
The Acquirer Landscape
Using our software, we also identified the key players shaping this market through algorithms that reveal similar companies and acquisition patterns.
The top acquirers paint an interesting picture of the space. Top buyout firm Bain Capital Private Equity leads the pack, leveraging its Boston-based platform to identify and execute deals across the ambulatory care spectrum. AmSurg itself appears as both a target and an acquirer, demonstrating the roll-up strategy that defines much of this sector.
Bon Secours Health System represents the strategic acquirer category, using acquisitions to expand its non-profit healthcare network. Meanwhile, Envision Healthcare shows how specialized service providers are building scale through targeted acquisitions in ambulatory surgery solutions.
Technology and Consolidation
The integration of technology is accelerating consolidation opportunities. The adoption of digital solutions and AI-driven rehabilitation programs is likely to further shape the future of PT services. Smart investors are looking for platforms that combine traditional care delivery with technological capabilities that can scale across multiple locations.
The Ambulatory Surgery Center News expects investors to swing big in 2025. Meanwhile, as investors are becoming more eager, and likely more aggressive, to get deals done, centers are still facing a lot of the same headwinds. This creates an interesting dynamic where motivated sellers meet aggressive buyers, often resulting in favorable deal terms for well-positioned assets.
The outpatient revolution isn’t slowing down. Tenet’s USPI division aims for more or less 600 centers by 2025, leveraging system alliances to secure physician alignment. This kind of ambitious expansion signals continued consolidation opportunities.
For dealmakers using software like our deal-sourcing tool, the ability to quickly identify comparable companies and track acquisition patterns becomes crucial. The AI-powered platform’s natural language processing capabilities help investors spot emerging trends and find targets that traditional database searches might miss.
The healthcare delivery model is changing, and smart money is positioning itself at the center of that transformation. And ambulatory care represents the perfect intersection of social good and profitable investment.
Curious about Finder and jumping in on this trend? Contact us to learn more.