If you’ve heard rumors that Ascension, one of the biggest nonprofit health systems in the U.S., is going out of business, that’s not the story. What is true: the company is making some big moves to get back on solid ground financially. It’s been a rocky few years, but closing up shop isn’t in their plans. Let’s dig into what’s really happening with Ascension, what’s changing, and, frankly, why so many people are asking these questions in the first place.
Where Ascension Stands: Not Collapsing, But Definitely Restructuring
First off, no, Ascension is not shutting its doors or filing for bankruptcy. If anything, this giant hospital system is in the thick of a restructuring phase—selling off certain hospitals, making strategic buys in new areas, and homing in on a plan to focus more on outpatient care. It’s the kind of pivot big businesses sometimes make when they need to improve finances, not a signal the whole thing is falling apart.
The company’s leaders have been fairly open about their strategy: they’re getting out of markets and buildings where they’re losing money, while investing in places and services that seem more promising for the future. For patients, much of this is behind the scenes, but it’s reshaping how the organization is run.
By the Numbers: Financial Hits, Small Wins, and Why It Matters
Let’s talk dollars, because that’s what most of these changes come down to. Ascension reported a recurring operating loss of $381 million over the first nine months of its fiscal year 2025. That’s still a big red number, but what grabs attention is that it’s a lot less bad than the year before—improved by about $1.4 billion compared to the previous fiscal cycle.
In just the most recent quarter (Q3 FY2025), they lost $68 million, though, again, that’s an improvement. So, you get the picture: Ascension isn’t where they want to be, but they’re moving in the right direction after some major hits.
The latest financial disclosures for the start of fiscal 2026 show a mixed bag. Overall patient service revenue is down by 16.4%, a drop that mostly reflects the fact they sold off a bunch of hospitals and so have fewer patients overall. But here’s a twist: revenues per patient (“per equivalent discharge”) are actually up by almost 18%. Basically, they’re making more money, on average, for every person who comes through the door thanks to better contracts and stronger insurance mixes. It’s a sign that cutting loose less profitable facilities might be working as planned.
Big Sales and Market Exits: Trimming Down to Refocus
A huge part of Ascension’s turnaround strategy has been selling off hospitals, especially in places where the math just doesn’t work anymore. In March 2025, Ascension handed over nine of its Illinois hospitals, plus some surgery centers and senior care facilities, to Prime Healthcare for $375 million. That’s a significant reshuffle in one of their bigger states.
Last summer, Michigan was next on the list. Ascension sold three hospitals and an ambulatory surgery center to MyMichigan Health, officially leaving that state’s hospital market. Shortly before, in June, they wrapped up the sale of St. Vincent’s Health System down in Alabama to UAB for somewhere around $450 million. These three states represented a big part of their footprint, but they were also costing the company more money than they brought in.
And those weren’t the only sales. In early 2025, they signed off on deals involving 13 hospitals, plus additional assets tied to their previous “Presence Health” and senior care operations. They even scaled back joint ventures, trimming partnerships like the one with Henry Ford Health System.
So, what does all this mean for staff and patients? There are job cuts, fewer facilities, and big adjustments for some communities. On paper, though, Ascension’s workforce has stabilized, and turnover improved. Their contract labor costs (those expensive temp gigs health systems have leaned on since COVID) have started to drop. Ascension’s internal stats show their 90-day employee retention is now running at 88.3%. That’s better than many in healthcare right now.
Spotlight on Outpatient Care: Why AmSurg Is a Big Deal
You might wonder where Ascension is putting the money it’s making from sales. One headline answer: outpatient care, which is where healthcare is headed, whether we like it or not. Hospitals may get all the attention, but outpatient clinics, surgery centers, and specialized facilities are where many patients want to go for convenience (and lower bills).
To that end, Ascension made a splash in June 2025 by agreeing to buy AmSurg, a leading operator of ambulatory surgery centers, for $3.9 billion. That’s not small change. AmSurg comes with more than 250 outpatient surgery centers in 34 states, with strengths in fields like GI, orthopedics, and eye care. The expectation from Ascension’s leadership is that this acquisition will immediately strengthen their bottom line and let them meet patients where they actually want to be treated—outside of traditional hospitals.
CEO Eduardo Conrado has said he wants Ascension to focus on “removing barriers to care.” In practical terms, that means making it easier (and quicker) for people to get outpatient surgeries and specialty care close to home, rather than navigating huge hospitals. There’s every indication this approach is going to be the centerpiece of Ascension’s plans moving forward.
Credit Ratings, Wall Street, and The View From the Outside
Even with steps in the right direction, Ascension isn’t entirely out of the weeds. This past September, Fitch Ratings downgraded its credit and bond ratings one notch to ‘AA’—not a disaster, but a sign there’s still plenty of financial pressure. The rating may sound technical, but it basically means investors aren’t worried Ascension will fail, they just want to see stronger results after these changes.
At the same time, major analysts and industry insiders view Ascension as a very active player in the hospital merger and acquisition world. The AmSurg purchase especially got the market’s attention, and with good reason—it could help the company lock in better profit margins in a sector where running big hospitals is just getting tougher.
Is there any talk of insolvency or closing down the company in the outside world? None that are credible. Industry sources describe Ascension as “stable” and focused on getting its financial house in order, not on bailing out altogether.
What’s Next: Future Outlook and Stability
So now, where does that leave one of America’s biggest nonprofit health networks? It’s safe to say Ascension is far from “business as usual,” but that’s exactly why they’re making these moves. Their leaders want to slim down to the most effective, profitable parts of their business and double down on outpatient care. The company is betting that by shifting focus—with big-ticket buys like AmSurg and offloading money-losing hospitals—they’ll be able to steady the ship and find growth again.
Hospital jobs and patient access will change in some places, for sure. Some communities have pushed back when their local hospital is suddenly for sale, and nobody welcomed contract layoffs. But Ascension’s moves fit broader trends in healthcare: fewer huge hospitals, more specialty and surgery centers, and more partnerships with private companies.
If you’re running a healthcare business or just like following big finance news, you can see some of the same themes playing out across the industry. More on hospital divestitures and strategy can be found at SmallBizPoint, where folks are keeping up with the business side of healthcare these days.
It’s tempting to treat every move a giant like Ascension makes as a sign of crisis, but the real story is more business as usual than end of the line. The health system is pivoting, experimenting, and frankly, doing what big organizations tend to do when times are tough: trim the fat, double down on what’s working, and look for the next big opportunity.
You’ll probably keep seeing headlines about more sales, maybe a few new outpatient launches, and updates on how people are adjusting to these changes. For now, Ascension isn’t going anywhere. It’s just trying to find a better way to be where healthcare is heading. The focus is steady, the spreadsheets are slimming down, and everyone is hoping this time, the strategy sticks.
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