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Is Tenet Healthcare Corporation (THC) A solid play on expanding ambulatory business? Published September 26, 2026 at 4:19 pm EDT Tenet Healthcare Corporation (NYSE:THC) is increasingly relying on its ambulatory business as an important driver of growth, combining favorable long-term outpatient trends with attractive margins. According to BMO Capital Markets, Tenet's ambulatory operations give the company exposure to an end market with favorable long-term growth characteristics. The firm expects continued investment in Tenet's hospital operations to support organic growth and help offset broader macroeconomic pressures. BMO initiated coverage of Tenet on September 22 with a Market Perform rating and a $265 price target. United Surgical Partners International (USPI), Tenet's ambulatory platform, had interests in 538 ambulatory surgery centers as of June 30. The business also operated 26 surgical hospitals across 37 states. In the second quarter, ambulatory revenue increased 9.3% year over year to $1.39 billion, highlighting the segment's continued contribution to Tenet's overall growth. The segment's profitability is also an important part of the investment thesis. Ambulatory EBITDA increased 8.8% in the second quarter, while adjusted EBITDA margin reached 39%. These results demonstrate the attractive economics of outpatient care and underscore how USPI is becoming an increasingly important component of Tenet's business mix. Risks to Tenet's ambulatory growth. Despite the growth opportunity, Tenet Healthcare Corporation's ambulatory business faces several risks that could affect the company's long-term financial performance and valuation. Tenet remains dependent on commercial insurers and government payers, making reimbursement policy an important consideration. Changes to Medicare payment rates or reimbursement policies could reduce the economic advantage associated with performing certain procedures in outpatient settings. USPI's business model also depends heavily on relationships with surgeons who bring procedures to its facilities. Competition from other ambulatory surgery center operators could make it more difficult to recruit and retain physicians. It could also increase the financial concessions required to maintain existing physician relationships. Acquisitions represent another potential risk. Tenet has expanded USPI through acquisitions and partnerships, but strong investor interest in the ambulatory surgery center market could drive acquisition multiples higher. Paying elevated valuations for new facilities could make it more difficult for Tenet to generate attractive returns on invested capital. Hedge fund positioning. Institutional investor activity provides another data point for investors watching Tenet Healthcare Corporation. According to Insider Monkey's database, the number of hedge funds holding Tenet shares increased to 61 in the second quarter from 57 in the first quarter. Several prominent funds also increased their positions. Glenview Capital increased its Tenet stake by 47% to approximately $418.25 million, while Citadel Investment Group increased its position by 322% to approximately $330.30 million. Short interest has also declined. The number of Tenet shares held short fell to 2.02 million as of September 15, from 2.52 million as of August 14. Short interest stood at approximately 2.50% of shares outstanding, indicating relatively limited short positioning around the stock. The verdict. Tenet Healthcare Corporation's expanding ambulatory platform has become an increasingly important part of its growth profile. USPI combines exposure to the continued migration of procedures toward outpatient settings with a relatively high-margin business model, while its scale offers opportunities to expand through partnerships and acquisitions. At the same time, investors need to monitor reimbursement changes, physician relationships, competitive pressures, and acquisition valuations. These factors could influence how effectively Tenet converts ambulatory growth into sustainable earnings and cash flow. The combination of ambulatory expansion, improving hedge fund participation, and declining short interest provides important context for investors assessing Tenet's growth outlook.

The 5 biggest health system ASC investments of 2026. By: Francesca Mathewes Some of the country's largest health systems have spent the past two years selling hospitals and redirecting capital to ASCs. In 2026, that shift has produced a $3.9 billion megadeal alongside a steady stream of single-site builds. Here are the six largest health system ASC investments announced, closed, broken ground on or opened between January and September, ranked by disclosed dollar value. The list includes only ASC-anchored deals and projects. 1. Ascension (St. Louis): $3.9 billion Ascension completed its $3.9 billion acquisition of Nashville, Tenn.-based AmSurg June 4, expanding its network to 300 ASCs. The deal closed two days after the Federal Trade Commission cleared it on the condition that Ascension divest seven AmSurg facilities. Six of those centers went to SC Affiliates, an Optum subsidiary. "Healthcare is increasingly moving beyond the traditional hospital setting, and this acquisition positions us to lead that transformation," said Eduardo Conrado, president and CEO of Ascension. 2. Tenet Healthcare (Dallas): $125 million Tenet spent $125 million acquiring seven ASCs in the first quarter through Dallas-based United Surgical Partners International, reaching half of its $250 million annual acquisitions target for the ASC subsidiary in three months. USPI held interests in 538 ASCs and 26 surgical hospitals across 37 states as of June 30. Saum Sutaria, MD, chair and CEO of Tenet, said the company remains selective and has a robust pipeline of centers interested in joining USPI this year. "We still say no to more centers than we say yes to," Dr. Sutaria said. 3. UM Health-Sparrow (Lansing, Mich.): $60 million UM Health-Sparrow broke ground June 22 on a $60 million ASC in Lansing, a project the University of Michigan Board of Regents approved in February alongside an $83 million behavioral health hospital. The center will open in 2028 with four operating rooms and space to expand, along with a new MRI unit. The ASC will take on procedures now performed at the system's St. Lawrence campus and cases from its Lansing hospital, where operating room capacity is nearing its limit. 4. WVU Medicine United Hospital Center (Bridgeport, W.Va.): $48 million United Hospital Center, part of Morgantown, W.Va.-based WVU Medicine, broke ground in February on a $48 million, 62,000-square-foot outpatient surgery center. The facility will have eight robotic-capable operating rooms for orthopedic and spine procedures, including same-day total joint replacements, plus shelled space for future growth. It will eventually connect to the main hospital. 5. Lee Health (Fort Myers, Fla.): $42 million Lee Health began construction on a $42 million, 60,000-square-foot pediatric surgery center on the campus of Golisano Children's Hospital of Southwest Florida and HealthPark Medical Center. The center is expected to open in early 2028. At the Becker's 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now. Tuesday, October 6 12:00 PM - 1:00 PM CDT Presenters: Amanda Whitener, nimble solutions|Chris Ballentine, nimble solutions Next up in ASC transactions & valuation issues. * Florida physician sentenced in $3.1M Medicare fraud scheme A Florida physician has been sentenced to probation for his role in a multimillion-dollar Medicare fraud scheme involving medically unnecessary... By: Patsy Newitt * Florida surgery center performs 1st procedures Watson Clinic Surgery Center South in South Lakeland, Fla., performed its first set of surgeries Sept. 21, with Watson Clinic... By: Hailey Bosek * Asante acquires closed ASC - reopening not planned yet Medford, Ore.-based Asante Health System bought the former Surgery Center of Southern Oregon building for $10.3 million on July 30... By: Francesca Mathewes

Tenet Healthcare Corporation has raised $2 billion through the issuance of 6.250% senior notes due 2034. The company will use the proceeds, along with cash on hand, to redeem $1.5 billion of its 5.125% senior secured first lien notes due November 2027 and $500 million of its 6.125% senior notes due October 2028. The new notes, issued on 22 September 2026, are senior unsecured obligations paying interest semi-annually. They mature on 15 September 2034. The refinancing extends Tenet's debt maturity profile and eliminates secured debt from its capital structure. The notes include optional redemption features and a change-of-control put at 101% of principal plus accrued interest. Before September 2029, redemption is available at 100% of principal plus a make-whole premium.