St. Louis-based Ascension is boosting its outpatient strategy, a pivot after years of acute care divestitures and operational realignment. Ascension is in advanced talks to acquire Nashville, Tenn.-based AmSurg, one of the largest ASC operators in the U.S., for about $3.9 billion. AmSurg runs more than 250 centers across 34 states, which would instantly give Ascension a major footprint in outpatient surgery. With a leaner acute footprint, the system now appears to be entering a new growth phase, one anchored in outpatient care. Ascension reported a fiscal 2025 operating loss of $490.9 million (a -1.6% operating margin), a significant improvement from its $1.8 billion loss (-6.3% margin) the prior year.