Healthcare Services Transactions Update — Q2 2025
Ankura is pleased to present an overview of healthcare services transactions announced or closed during Q2 2025 in the United States. Total transactions increased by 3.0% in the second quarter of 2025 after decreasing by 8.3% in the first quarter. Compared to Q2 2024, transaction volumes for Q2 2025 were down by 9.5%.
Notable Transactions Announced or Closed in Q21
- Ascension Health entered into a definitive agreement to acquire AmSurg on June 2, 2025, for $3.9 billion, implying a 3.6x price to revenue multiple and a 15.8x price to EBITDA multiple. Amsurg owns and operates ambulatory surgery centers (ASCs) throughout the U.S.
- GI Alliance, a subsidiary of Cardinal Health, entered into a definitive agreement to acquire Urology America on April 30, 2025. Urology America provides urology services across Colorado, Louisiana, Tennessee, and Texas, with over 110 providers operating at 30 locations.
- Concentra entered into a definitive agreement to acquire Pivot Onsite Innovations on April 21, 2025, for $55 million, implying a 0.9x price to forward revenue multiple and an 8.9x price to forward EBITDA multiple. Pivot Onsite Innovations provides onsite occupational health services across the U.S.
- Bain Capital entered into a definitive agreement to acquire HealthEdge on April 10, 2025, for $2.6 billion, implying a 6.5x price to revenue multiple and a 30.2x price to EBITDA multiple. HealthEdge is a Software as a Service (SaaS) company providing digital solutions to health plans, providers, and patients.
- RadNet, Inc. (NASDAQ: RDNT) entered into a definitive agreement to acquire iCAD, Inc. (NASDAQ:ICAD) on April 15, 2025, for approximately $3.61 per share. The purchase price implies an $85.8 million enterprise value, or a 4.4x price to revenue multiple. iCAD offers artificial intelligence (AI)-driven cancer detection solutions with a focus on breast cancer screening.
Key Observations
Total transaction activity in the second quarter of 2025 increased slightly over the prior quarter for the healthcare services industry. However, these levels still remain significantly below the activity observed over the past few years. While inflation continued to ease in the second quarter, potential buyers continued to deal with higher borrowing costs as the Federal Reserve maintained the target federal funds rate.
Healthcare operators received mixed news with the passage of the One Big Beautiful Bill Act (OBBBA) on July 4, 2025. While the tax provisions included are generally beneficial to corporations, the OBBBA cuts $1 trillion from federal healthcare funding over the next decade, which will have a significant impact on certain healthcare sectors. For more insights on the OBBBA, explore Ankura’s article diving into the implications of the OBBBA for the healthcare industry.
Despite expectations of reduced regulatory barriers under the Trump administration, federal agencies sent mixed signals regarding their intent for regulatory oversight in certain healthcare sectors. Several actions by federal agencies in the second quarter indicated an intent for heightened oversight. For example, the Department of Justice (DOJ) and the Federal Trade Commission (FTC) held listening sessions to investigate anticompetitive practices in the pharmaceutical industry, the DOJ and the Department of Health and Human Services (HHS) relaunched the False Claims Act Working Group, and the Office of Inspector General (OIG) issued mixed advisory opinions for healthcare companies. In contrast, the DOJ recently reached a settlement allowing United Health Group to continue its acquisition of Amedisys. While this settlement does require Amedisys and United Health Group to divest 164 home health sites, some experts still believe this decision is a result of the Trump administration’s business-friendly approach.
Investors also continue to face heightened regulatory scrutiny at the state level, with legislation being passed or introduced in several states, which could curb future healthcare acquisitions. Oregon passed new legislation which is widely considered to be the most restrictive in the country, significantly limiting the management services organization (MSO) model in healthcare. Massachusetts increased requirements for transaction notifications, and California has re-introduced bills targeting private equity investment in healthcare and the MSO model despite being vetoed last year.
As shown in the figures below, recent healthcare acquisitions continued to be dominated by three sectors making up 76.1% of transactions in Q2: Professional Services[2], Outsourced Services[2], and Behavioral Health. The Professional Services sector remained the most active sector in terms of total transactions as a result of continued interest from health systems and private equity buyers alike, accounting for 54.9% of total deal volume.
In the Professional Services sector, most of the growth in transaction activity occurred in the dentistry space. Much of the transaction activity in dentistry was driven by add-on acquisitions by private equity-backed platforms such as Heartland Dental and MB2 Dental.
Behavioral Health transactions declined by approximately 10.2% in the second quarter. While President Donald Trump’s OBBBA was not passed until the end of the quarter, investors may have been hesitant to invest in the Behavioral Health space due to the sector’s general reliance on Medicaid.
Specialty Outpatient Services saw a 44.4% increase in total transactions. While most transactions in this sector involve the acquisition of small operators of diagnostic imaging centers or ASCs, the industry also saw the announcement for the acquisition of AmSurg, one of the largest surgery center operators in the U.S., by Ascension Health. The acquisition of AmSurg continues the trend of health systems making strategic investments in outpatient care.
During the quarter, Ankura’s Transaction Advisory practice provided guidance on a diverse range of deals across the sector, including transactions in dentistry, behavioral health (spanning autism services, addiction treatment, and psychiatry), physician practices, and long-term care services.
Future Outlook
Looking toward the second half of 2025, healthcare investors will closely monitor economic indicators, including inflationary pressures, borrowing costs, and regulatory requirements at both the federal and state level. While inflation has trended downward since Trump took office, most industry participants are concerned the recent tariff announcements could lead to higher costs in the short-term. The Federal Reserve is also expected to cut rates in September of this year, which could spur transaction activity.
We anticipate an increase in transaction activity in the second half of the year, with a more focused approach on specific geographic regions and healthcare sectors due to anticipated impacts from the OBBBA and regulatory scrutiny.
About Ankura Healthcare Transaction Advisory Services
Healthcare transactions are inherently complex. With deep industry experience, Ankura delivers insights to make informed investment decisions in mergers, acquisitions, and partnerships.
Ankura’s Healthcare Transaction Advisory team is deeply rooted in the healthcare sector, leveraging extensive industry knowledge and expertise to anticipate critical financial accounting aspects of transactions while also understanding the operational drivers. This enables us to proactively address critical financial accounting aspects and operational drivers of transactions.
What sets us apart is the collaboration between our financial accounting due diligence experts and Ankura's specialized teams in healthcare valuation, healthcare operations, tax, information technology, commercial strategies, and human capital. This collaboration ensures a seamless, integrated reporting process for you, combining diverse expertise to provide a holistic view of every transaction. Our approach guarantees that you receive nuanced, actionable insights in a unified and strategic manner.
With senior deal professionals engaged in every transaction phase, we provide immediate updates on significant deal factors and a dedicated analysis of any critical issues, ensuring a thorough understanding and resolution of underlying concerns.
Connect with one of our Healthcare Transaction Advisory experts to navigate the complexities of healthcare with confidence. Meet our dedicated professionals at the link below and reach out to us for more information.
Learn more: Healthcare & Life Sciences Transaction and Valuation Advisory - Ankura.com
References:
[1] Sources: Scope Research Healthcare M&A Volume Database, published by Scope Research; Capital IQ
[2] The Professional Services sector includes dentistry, physical therapy, physician practices, urgent care, veterinary, and other clinics. The Outsourced Services sector includes billing, revenue cycle, management services organizations, marketing, staffing, and other services commonly outsourced by medical practices.
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© Copyright 2025. The views expressed herein are those of the author(s) and not necessarily the views of Ankura Consulting Group, LLC., its management, its subsidiaries, its affiliates, or its other professionals. Ankura is not a law firm and cannot provide legal advice.
