ARTICLE
June 30, 2026
Read time: 7 min
The healthcare services market is entering a new phase of development, according to discussions at McDermott HealthEx 2026. Site-of-care migration continues to drive growth across physician practice management (PPM) platforms, ambulatory surgery centers (ASCs), and outpatient services, creating a host of new transaction opportunities and evaluation priorities.
Successful M&A strategy is no longer about simply building scale. It’s about converting scale into stronger margins, better operational performance, and long-term sustainable value.
Below are the hot trends and takeaways from McDermott HealthEx to guide the next phase of outpatient services growth and dealmaking strategies for ASCs and PPMs.
What buyers want
Buyers are paying closer attention to earnings durability and execution quality in the face of a more selective exit environment, persistent reimbursement pressures, regulatory enforcement at state and federal levels, and rising operating costs. They are spending less time underwriting acquisition opportunities and more time evaluating whether a platform can expand margins, recruit physicians, integrate operations, and sustain performance – without relying on additional M&A.
Fragmentation across many specialties continues to create opportunities for consolidation, but aggregation alone no longer commands the same premium. Investors want to understand what sits beneath the roll-up strategy. The strategy discussion has moved from “Can this platform grow?” to “What happens when growth slows?”
This shift in thinking is influencing valuation, diligence, and value creation plans. Revenue growth remains critical, but the ability to demonstrate margin durability, operational consistency, and scalable infrastructure carries just as much weight.
Outpatient services help health systems stand out
Hospital outpatient revenue growth now outpaces inpatient revenue growth by nearly double, and that has changed the game for health systems. Physician partnerships, ambulatory platforms, and outpatient networks are increasingly tied to a health system’s long-term competitive positioning and financial performance, especially as patients gain access to better tools to find and compare care options.
To expand capabilities and enter new markets, it’s not all about traditional acquisitions. Health systems are leaning on joint ventures, shared governance structures, and other collaborative arrangements. The structure of the partnership often matters less than other fundamentals, including governance design, clinical integration, cultural compatibility, and operational alignment post-close.
Physicians have to be on board
Platform executives are looking beyond acquisition volume to other dealmaking considerations crucial for success. Chief among them is physician alignment, along with workforce strategy, productivity, and leadership development potential. Investors are responding accordingly, knowing that compensation structures, governance frameworks, and clinical autonomy all have an influence on physician recruitment, workforce retention, and long-term organizational performance.
For buyers, physician alignment has become a core diligence issue because it often serves as a leading indicator of future execution. Valuation discussions must extend well beyond market density and growth rates. Buyers want evidence that management teams can convert scale into stronger financial performance, more efficient operations, and sustainable enterprise value – an evolution that’s particularly evident across mature PPM platforms.
The strategic emphasis has shifted from simply building physician networks to optimizing them by:
- Improving physician workflows and productivity
- Strengthening ancillary service utilization
- Enhancing patient access and market presence
- Investing in better digital services and engagement tools
- Creating operating leverage across the enterprise
Regulatory strategy is enterprise strategy – not just compliance
Regulators at the state and federal levels have their eyes on the healthcare services market. State transaction review laws, ownership disclosure requirements, evolving reimbursement policies, and heightened scrutiny of healthcare consolidation are influencing transaction structures, diligence processes, and execution timelines in the space.
Medicare, Medicaid, site-of-care reimbursement policies, and value-based reimbursement models are shaping strategic decisions far beyond the compliance function. Growth initiatives, partnership strategies, market expansion plans, and capital deployment decisions increasingly require an assessment of reimbursement and regulatory risk at the outset rather than later in the process.
Organizations that incorporate those considerations into strategic planning are generally better positioned to preserve value and avoid execution surprises while navigating an increasingly complex transaction environment.
Key considerations for outpatient services transactions
With these trends in mind, outpatient service operators, investors, and strategic buyers should evaluate dealmaking strategies and transaction processes according to a few key considerations.
For PPM and ASC operators:
Revenue cycle performance, labor productivity, physician recruitment and retention, payor strategy, and operational standardization are becoming more important drivers of enterprise value.
For investors, strategic buyers, and lenders:
Leadership depth, physician alignment, revenue cycle performance, and integration readiness increasingly influence valuation and post-close performance.
Looking ahead
The next phase of outpatient services growth and dealmaking activity is unlikely to be defined by consolidation. The organizations that distinguish themselves over the next several years will be those that convert scale into stronger operating performance, pair growth with disciplined execution, and build platforms capable of performing across a more demanding reimbursement and regulatory landscape.
