Tenet Healthcare Corporation (NYSE: THC) on Monday announced a strategic transaction involving health care services company Conifer Health Solutions.
Strategically, the move reduces Tenet’s balance sheet and potentially sets the stage for a stronger 2025 financial performance. In turn, the transaction could also indirectly bolster growth around Tenet’s large ambulatory surgery center (ASC) platform, United Surgical Partners International (USPI).
“The transaction will enable a thoughtful, collaborative transition over the coming year,” Saum Sutaria, chairman and CEO of Tenet, said in a statement.
Tenet’s partner in the transaction is CommonSpirit Health, one of the nation’s largest nonprofit health systems, operating hospitals, outpatient facilities and care sites across more than 20 states. CommonSpirit became involved with Conifer – launched in 2008 by Tenet as a subsidiary focused on providing revenue-cycle management (RCM) and value-based care services – as part of a long-standing revenue cycle partnership that included an equity stake.
In its Monday announcement, the Dallas-based hospital and ASC operator explained that CommonSpirit Health will pay roughly $1.9 billion over three years as part of the Conifer agreement.
In short, CommonSpirit is paying up to end its standing RCM agreement.
As part of the transaction, Conifer will make a roughly $540 million redemption payment to eliminate CommonSpirit’s 23.8 % equity stake, effective Jan. 1, 2026.
“This transaction will result in a reduction of Tenet’s redeemable non-controlling interest and other liabilities on its balance sheet of approximately $885 million and an increase to Tenet’s additional paid in capital of approximately $305 million,” noted the announcement.
Also on Monday, Tenet previewed its preliminary results for full-year 2025, forecasting adjusted EBITDA near the top of its guidance range of $4.47 billion to $4.57 billion, citing strong same-store revenue growth and disciplined expense management. The company will report fourth-quarter and full-year results on Feb. 11.
“We continue to deliver strong revenue growth, improved margins and attractive free cash flow as a result of effective execution of our strategies,” Sutaria continued.
Again, while not directly tied to ambulatory operations, the transaction underscores Tenet’s broader effort to streamline its portfolio and strengthen its financial foundation.
Such moves have particular relevance for USPI, one of the largest ASC platforms in the United States and a core growth engine for Tenet. USPI operates hundreds of ASCs and surgical hospitals nationwide.
A leaner debt profile and improved liquidity could give Tenet even more flexibility to support USPI’s expansion through mergers, acquisitions and de novo development.
“We have already spent nearly $300 million on M&A in this space year to date and expect to continue adding additional centers in the fourth quarter, as the M&A and de novo pipelines remain strong,” Sutaria said during the company’s Q3 2025 earnings call on Oct. 28. “The ASC opportunity has many dimensions, given the growth platform we have built at USPI.”
The Conifer transaction will also support more investment around the solution, according to Tenet.
“This milestone gives Tenet greater flexibility to support Conifer’s long-term potential,” Monday’s announcement continued. “Conifer will expand its investments in artificial intelligence, automation and global operating capabilities, reflecting its commitment to innovation and market leadership in revenue cycle management services.”
Analysts on Monday appeared mostly bullish on the news.
“While we understand investor concerns about losing a large contract, our call with mgmt. reinforced that the transaction is best understood as an economic pull‑forward of future significant economic value and eliminating future payout obligations at a fair valuation,” an analyst note from Jefferies explained. “We would also be remiss if we did not acknowledge the FY25 EBITDA beat of +0.9% vs the Street.”
