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Ambulatory Surgery Center Transactions

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Our Ambulatory Surgery Center (ASC) Transactions Team combines deep industry knowledge with practical, business-focused solutions derived from experience with many dozens of ASC transactions across the country.

Overview


Our Ambulatory Surgery Center (ASC) Transactions Team combines deep industry knowledge with practical, business-focused solutions derived from experience with many dozens of ASC transactions across the country. We deliver tailored business-oriented strategies that align with each ASC's objectives and market dynamics.

Our Experience in ASC Transactions

Baker Donelson has extensive experience advising ASCs of all sizes nationwide on a vast array of strategic transactions to position them for success, including:

  • Sales, divestitures, and consolidations with national management companies, investors, and private equity-backed platforms
  • Acquisitions of ASCs by buyers of all sizes, including large ASC networks and chains
  • Mergers and consolidations with hospital systems and joint venture partners
  • Syndication with physicians and other investors
  • ASC and office-based labs (OBL) development/formation among physicians in different specialties (and investors)

Regulatory Compliance

Our team has decades of experience navigating the complex regulatory requirements that affect ASCs and play a critical role in due diligence for these transactions. Our attorneys provide guidance on:

  • Anti-Kickback Statute compliance and similar state laws, including financial relationship structuring, referral arrangements, ASC safe harbor provisions, and compliant buy-ins and redemptions
  • Certificate of need and licensing regulations for each state
  • Accreditation and survey issues
  • Medicare and Medicaid regulations, including billing, documentation, provider enrollment, change of ownership, and reimbursement requirements
  • State health care transaction review laws, which can elongate the sign-to-close period and introduce regulatory risk into the dealmaking process
  • HIPAA compliance, including business associate agreements, cybersecurity policies, and breach notification requirements
  • Federal and state employment and benefits laws, including overtime laws, family leave laws, anti-discrimination laws (disability/Americans with Disabilities Act, racial, age, gender, etc.), and ERISA/benefit plan compliance
  • General Physician Transactions

  • "The Intersection of PE and MSOs, Part 1: Benefits and Pre-Transaction Considerations," CV Transforum Fall '24 Conference (October 2024)
  • "Private Equity Physician Deals: What Investors, Physicians, and Hospitals Need to Know in 2023," American Health Law Association (AHLA) Health Care Transactions 2023 Conference (April 2023)
  • "The Anatomy of a Private Equity Transaction and Process," 6th Annual Physician Transactions Conference: The Future of Healthcare Conference Series™ (March 2023)
  • "The (Still) Robust Market for Physician Groups," 6th Annual Physician Transactions Conference, The Future of Healthcare Conference Series™ (March 2023)
  • "The Anatomy of a Physician Group Transaction with Private Equity," 2022 Physician Transactions Conference (March 2022)
  • "Key Terms and Protections for Physicians in Sale Transactions," Physician Transactions Conference, The Future of Healthcare Conference Series® (February 2022)
  • "The Process of Undergoing a Strategic Medical Practice Transaction," 2021 Physician Transactions Conference (April 2021)
  • "Assessing Strategic Options and Practice Value in the Wake of the Pandemic," 2021 Physician Transactions Conference (April 2021)
  • "Exit Planning and Strategic Transactions for Physician Groups," AllianceBernstein (June 2020)
  • "Part 3: The Transaction Process, Key Protections for Physicians, and How to Prepare," Physician Group Transactions 2020 (May 2020)
  • "Part 2: Beyond the First Partnership – Second Bites and More," Physician Group Transactions 2020 (April 2020)
  • "Part 1: What's Going On, and What Do You Need to Know?," Physician Group Transactions 2020 (April 2020)
  • "Physician Group Strategic Transactions on the Rise," The Future of Health Care Conference Series (April 2019)
  • Orthopedics

  • "Anatomy of a Partnership Transaction: What to Expect at Each Stage," 2025 Physician Transactions Conference: Orthopedic & Spine, The Future of Healthcare Conference Series® (March 2025)
  • "A New Strategic Option to Consider – ESOPs for Medical Groups," 2025 Physician Transactions Conference: Orthopedic & Spine, The Future of Healthcare Conference Series® (March 2025)
  • "Keynote Panel: 'Life After Closing' of a Partnership Transaction from the Perspective of Orthopedic Surgeons Who Pursued Different Strategic Options," 2025 Physician Transactions Conference: Orthopedic & Spine, The Future of Healthcare Conference Series® (March 2025)
  • "How to 'Extricate' from a Hospital PSA or Employment Agreement that is Not 'Working Out' to Participate in a Strategic Transaction," 2025 Physician Transactions Conference: Orthopedic & Spine, The Future of Healthcare Conference Series® (March 2025)
  • "How Orthopedic & Spine Groups Are Valued and How to Maximize Practice Value by Getting Your House in Order," 2025 Physician Transactions Conference: Orthopedic & Spine, The Future of Healthcare Conference Series® (March 2025)
  • "How to Navigate the Changing Competitive Landscape: Partnership Strategies for Orthopedic Group Executives," AAOE (January 2025)
  • "Private Orthopedic Groups: Latest Updates, Pros & Cons, Second Bites, 'Life After Closing,' and Other Strategic Options," AAHKS Annual Meeting 2024 (November 2024)
  • "Private Equity in Orthopedics: Opportunities, Challenges, and Strategic Insights," American Alliance of Orthopaedic Executives (AAOE) 2024 Annual Conference (April 2024)
  • "Optimizing Your Program's Value: Pre- and Post-Transaction Strategies," CV Transforum Spring 2024 Conference (April 2024)
  • "State-of-the-State of Orthopaedics: Private Equity and Mergers/Acquisitions in Health Care: Acquisitions in Health Care," American Academy of Orthopedic Surgeons (AAOS) 2024 Annual Meeting (February 2024)
  • "Mini-Symposium on Private Equity & Orthopedic Surgeons," AAHKS Annual Meeting 2023 (November 2023)
  • "Returns, Risks, and Rewards: Structuring Strategic Transactions for ASCs and Surgery Groups," 29th Annual Becker's ASCS Conference (October 2023)
  • "Deep Dive on Private Equity Deals for Orthopaedic Groups," Orthopaedic Summit 2023 (September 2023)
  • "Latest Trends on Orthopaedic Group Transactions and Outlook for Q4 of 2023 & 2024," Orthopaedic Summit 2023 (September 2023)
  • "The Top Reasons Why So Many Orthopaedic Groups Are Pursuing Private Equity Transactions," Orthopaedic Summit 2023 (September 2023)
  • "How to Extricate Yourself from a Hospital PSA or Employment Agreement to Be Able to Benefit from a Lucrative Private Equity Transaction," Orthopaedic Summit 2023 (September 2023)
  • "Life After Closing of a PE Deal, from the Perspective of Six Mid-Career Orthopaedic Surgeons Who Partnered with Six Different Private Equity Platforms," Orthopaedic Summit 2023 (September 2023)
  • "How to Maximize Your Practice's Value by 'Getting Your House in Order'," Orthopaedic Summit 2023 (September 2023)
  • "Understanding Private Equity: Is It for You?," American Orthopaedic Society for Sports Medicine (AOSSM) Annual Meeting (July 2023)
  • "Strategic Transactions for Spine, Orthopedic, and Pain Management Groups," Spine, Orthopedic + Pain Management-Driven ASC Conference (June 2023)
  • "Contract Negotiations for the Young Arthroplasty Surgeon," American Association of Hip and Knee Surgeons (AAHKS) Fellows Orthopaedic Continued AAHKS Learning (FOCAL) Committee (November 2020)
  • Cardiology & Vascular

  • "How to 'Extricate' from a Hospital PSA or Employment Agreement that is Not 'Working Out' to Participate in a Strategic Transaction," 2025 Physician Transactions Conference: Cardiology, The Future of Healthcare Conference Series® (March 2025)
  • "How Cardiology Groups Are Valued and How to Maximize Practice Value by Getting Your House in Order," 2025 Physician Transactions Conference: Cardiology, The Future of Healthcare Conference Series® (March 2025)
  • "Anatomy of a Partnership Transaction: What to Expect at Each Stage," 2025 Physician Transactions Conference: Cardiology, The Future of Healthcare Conference Series® (March 2025)
  • "A New Strategic Option to Consider – ESOPs for Medical Groups," 2025 Physician Transactions Conference: Cardiology, The Future of Healthcare Conference Series® (March 2025)
  • "Keynote Panel: 'Life After Closing' of a Partnership Transaction from the Perspective of Cardiologists Who Pursued Different Strategic Options," 2025 Physician Transactions Conference: Cardiology, The Future of Healthcare Conference Series® (March 2025)
  • "Maximizing Value and Protecting Physicians in Strategic Partnerships," MedAxiom, an American College of Cardiology Company (September 2024)
  • "Private Equity Partnerships with Physicians in Hospital Relationships – Navigating the Waters," MedAxiom, an American College of Cardiology Company (July 2024)

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