Over the past 10 years, hospital health systems have increasingly formed joint ventures with outpatient Management Services Organizations (MSOs) to optimize operations, expand service offerings, and share financial and operational risks. The structure and volume of these joint ventures vary depending on the geographic region and specific market dynamics.
Many health systems have partnered with MSOs to manage and operate ASCs due to the growing demand for outpatient surgical services. Health systems like Baylor Scott and White, Tenet Healthcare, and John Muir Health have entered into multiple joint ventures to develop and expand ASC networks, resulting in a significant rise in outpatient surgery volume
Due to tighter margins and the need for efficient resource allocation, health systems have formed joint ventures targeting value-based care initiatives. These ventures often focus on outpatient growth and integration with primary care and specialist groups
Systems like LHP Hospital Group have been involved in numerous joint ventures with non-profit entities across states like Texas, New Jersey, Florida, and Idaho, focusing on expanding access to care and sharing administrative resources
Joint ventures are often subject to complex legal frameworks, including the Stark Law, Anti-Kickback Statute, and regulations related to tax-exempt status for non-profit entities. This necessitates thorough compliance analysis to ensure that the ventures are structured legally and maintain operational efficiency
The largest players with around 10 major joint ventures targeting the ASC and outpatient care market.
Approximately five joint ventures with smaller non-profit systems spread across multiple states.
Several partnerships focused on outpatient and ASC development, primarily in California and Arizona.
Over the past 10 years, hospital health systems have increasingly formed joint ventures with outpatient Management Services Organizations (MSOs) to optimize operations, expand service offerings, and share financial and operational risks. The structure and volume of these joint ventures vary depending on the geographic region and specific market dynamics.
GoHealth Urgent Care has established multiple joint ventures with health systems like Dignity Health, Northwell Health, and Novant Health to expand urgent care services in states like California, New York, and North Carolina.
Emory Healthcare and PeachTree Immediate Care in Atlanta, Georgia, entered into a partnership to build and manage over 20 urgent care centers.
Cleveland Clinic and American Family Care have partnered to operate several urgent care centers in Northeast Ohio, integrating them into the larger health system’s continuum of care.
Joint ventures between hospitals and radiology groups have been common due to reimbursement challenges and the need for new capital investment. Outpatient Imaging Affiliates (OIA) has partnered with health systems like Emory Healthcare and UNC Health Care to develop imaging centers.
HCA Healthcare and Mednax entered a JV to form a network of imaging facilities focused on pediatric radiology services.
Southeastern Academic Medical Center formed a JV with an imaging group to elevate patient and physician satisfaction through advanced imaging services.
Orlando Health and Acadia Healthcare created a JV to build a network of behavioral health hospitals in the Southeast U.S., focused on expanding access to mental health services.
Acadia Healthcare also partnered with other systems, including Tufts Medicine and Ascension, to operate behavioral health hospitals and provide psychiatric services.
Providence Health and Universal Health Services recently announced a JV to develop a 100-bed behavioral health facility in Washington state.
NorthStar Anesthesia has been involved in multiple JVs with hospitals like CHRISTUS Health and Tenet Healthcare, focusing on streamlining anesthesia services and achieving cost efficiencies.
US Anesthesia Partners and Baylor Scott & White Health entered a JV to optimize anesthesia services across the latter’s hospital network
Optum has partnered with various hospital systems, including Scripps Health and New York’s Northwell Health, to integrate and manage primary care clinics, leveraging Optum’s MSO expertise.
Tenet Healthcare and Baylor Scott & White Health have formed several JVs targeting primary care and multispecialty clinic growth in Texas.
Ascension and Emerus developed a series of micro-hospitals in Wisconsin to cater to underserved areas with a combination of ER and outpatient services, allowing for a smaller-scale approach to acute care.
CommonSpirit Health and Intuitive Health created a JV to expand the hybrid ER-urgent care model across multiple states .
Fresenius Medical Care and DaVita Healthcare Partners have formed numerous JVs with health systems like Trinity Health and Intermountain Healthcare to deliver both inpatient and outpatient dialysis services in various states.
US Oncology Network has formed partnerships with several regional health systems, such as Baylor Scott & White and McLaren Health Care, to establish comprehensive cancer treatment centers.
HCA Healthcare and Sarah Cannon Cancer Institute have been involved in several JVs targeting cancer research and treatment programs in the Southeast U.S.
Pacific Dental Services partnered with various health systems to integrate dental care within hospital settings, focusing on both adult and pediatric dental services.
Smile Brands entered into joint ventures with regional hospital groups like Midwest Dental to create dental clinics adjacent to existing primary care facilities.
OrthoIndy and Community Health Network formed a JV to build a dedicated orthopedic hospital in Indiana.
HSS (Hospital for Special Surgery) and Cedars-Sinai entered into a partnership to develop a musculoskeletal-focused outpatient center in Los Angeles.
United Surgical Partners International (USPI), a subsidiary of Tenet Healthcare, has partnered with over 300 hospitals and physician groups to manage ambulatory surgery centers (ASCs) nationwide.
Surgery Partners has been actively forming JVs with hospitals like TriStar Health and HealthONE to expand ASC operations in the Southern and Midwestern U.S.
Children’s Hospital Colorado and University of Colorado Health have partnered on several JVs focused on expanding pediatric specialty care and surgical services.
Nemours Children’s Health and AdventHealth formed a JV to integrate pediatric primary care into existing hospital networks in Central Florida.
We at SCALE suspect this information is directionally accurate and important to share, but we have only been able to get into some of the back-up data – the primary driver of this supporting information is press releases which are had to tabulate over decades.
GoHealth Urgent Care has established multiple joint ventures with health systems like Dignity Health, Northwell Health, and Novant Health to expand urgent care services in states like California, New York, and North Carolina.
Emory Healthcare and PeachTree Immediate Care in Atlanta, Georgia, entered into a partnership to build and manage over 20 urgent care centers.
Cleveland Clinic and American Family Care have partnered to operate several urgent care centers in Northeast Ohio, integrating them into the larger health system’s continuum of care.
Pacific Dental Services and Midwest Dental partnered to integrate dental care into primary care facilities.
US Anesthesia Partners continued expansion with CHRISTUS Health in Texas.
Children’s Hospital Colorado joined forces with University of Colorado Health to expand pediatric specialties.
OrthoIndy and Community Health Network launched a dedicated orthopedic hospital in Indiana.
United Surgical Partners International (USPI) and TriStar Health partnered to create and manage new surgery centers.
HSS and Cedars-Sinai formed a JV for a musculoskeletal-focused outpatient center in Los Angeles.
Providence Health partnered with Fairfax Behavioral Health to develop a new 100-bed behavioral health facility.
Orlando Health and Acadia Healthcare announced a JV to expand behavioral health services in Florida.
Cleveland Clinic partnered with American Family Care to integrate urgent care centers into its network.
Surgery Partners and HealthONE formed a JV targeting outpatient surgery expansion.
Smile Brands entered a partnership with Midwest Dental to build dental clinics adjacent to primary care facilities.
US Oncology Network collaborated with Baylor Scott & White Health to create cancer treatment centers.
Intuitive Health partnered with CommonSpirit Health for hybrid ER and urgent care models.
Tenet Healthcare expanded its JV with Baylor Scott & White to include multispecialty outpatient services.
Outpatient Imaging Affiliates developed a new imaging network with UNC Health.
Ascension and Emerus Holdings developed a micro-hospital network.
Optum partnered with Northwell Health to manage primary care clinics.
Atlantic Health and MedExpress formed a JV for urgent care services.
Providence Health and Universal Health Services launched a freestanding behavioral health facility.
St. Louis Children’s Hospital and Shriners Hospital partnered for pediatric orthopedic care.US Anesthesia Partners continued expansion with CHRISTUS Health in Texas.
DaVita and Trinity Health created a JV to manage inpatient and outpatient dialysis services.
HCA Healthcare and Sarah Cannon Cancer Institute expanded a cancer research and treatment network
OrthoVirginia entered a JV with Bon Secours Health for comprehensive orthopedic services.
Children’s National Hospital and HCA Healthcare collaborated to provide expanded pediatric care.
Fresenius Medical Care and Intermountain Healthcare created a JV to manage dialysis services in Utah.
Tenet Healthcare and Mednax partnered for women’s health and maternal services.
Smile Brands and Optum launched a dental care JV, targeting integration with existing primary care facilities.