By Heather Landi - Fierce Healthcare
Additional access points bring new patients into the Ardent Health network while creating enhanced capacity to serve patients within the system's clinics and emergency departments.
Ardent Health is making good on its ambitions to grow its footprint in ambulatory care through acquisitions.
The for-profit system kicked off 2025 by buying 18 urgent care clinics across New Mexico and Oklahoma from NextCare Urgent Care.
Financial details of the transaction were not disclosed. The purchase follows Ardent Health’s acquisition of nine additional urgent care centers in its East Texas and Topeka, Kansas, markets in 2024.
Ardent Health went public in July, raising $192 million in its IPO with plans to use the proceeds for working capital and to fund acquisitions, with a particular focus on expanding ambulatory services and outpatient sites of care. The company runs 30 acute care hospitals in six states, with 18 of those hospitals operated under joint ventures with other healthcare providers.
"This has been a great opportunity for us to continue to expand on what we had stated when we went public, which was continuing to invest in our markets and making it easier for consumers and patients to be able to access our health system," Ardent Health President and CEO Marty Bonick said in an exclusive interview with Fierce Healthcare about the NextCare Urgent Care clinic acquisitions.
"Our belief is that patients don't live in a point solution universe. We've got people that have chronic conditions, comorbidities and they're going to need different types of healthcare at different points of their life cycle. We think urgent care is a great access point into our system. Not everybody needs hospitalization or ER care, and so urgent care is a great alternative for people that have lower-level urgent needs and don't necessarily need to make a primary care visit for," Bonick said.
Many hospitals are investing in ambulatory and urgent care facilities to meet the growing demand for outpatient care services.
These additional access points also bring new patients into the Ardent Health network while creating enhanced capacity to serve patients within the system's clinics and emergency departments, Bonick noted.
"We believe it fits into a continuum of care that when patients come to that urgent care, if they don't have a primary care physician, we can introduce them to our primary care network, or our specialists. We think it's just a great way to provide care on people's terms, where and when they need it most," he said.
Pursuing opportunities in ambulatory care
NextCare is one of the largest providers of urgent care and occupational medical services in the U.S., operating more than 179 clinics in 12 states, according to its website.
The Ardent Health transaction includes six urgent care clinics in New Mexico, which will operate as part of Lovelace Health System, and 12 clinics in Oklahoma that will become part of Hillcrest HealthCare System. The acquisition significantly expands Ardent Health’s ambulatory operations in both markets. Through its subsidiaries, the company currently operates five hospitals and 25 sites of care in New Mexico as well as eight hospitals and 57 sites of care in Oklahoma.
Along with New Mexico and Oklahoma, the healthcare provider operates hospitals and other sites of care in Idaho, Kansas, Texas and New Jersey. The company focuses on growing in midsized urban communities.
"We had three strategies coming out of the IPO for growth. One was expanding the markets that we're in and going bigger and broader beyond the hospitals. We've got strong hospitals and strong leading market share positions in the majority of our markets, first or second, but we wanted to expand that ambulatory component," said Bonick, who joined the company as CEO in 2020.
In Tulsa and Albuquerque, where these acquisitions were made, urgent care penetration is high and Ardent Health didn't want to build new facilities in an already saturated market, he noted.
"By making this acquisition and bringing them into the Ardent fold, into the local Hillcrest and Lovelace brands in those Tulsa and Albuquerque markets, respectively, that's going to allow us to just create that seamless continuum of care, and it's going to allow us to go further faster. These are established clinics that already have a patient referral base. We're going to be able to integrate these and they already have visible awareness in their community locations. This is going to help us to grow and go faster in those markets to further integrate care into our system," he said.
Ardent Health will continue to eye M&A opportunities, Bonick said.
"You still have a lot of hospitals that are still struggling and haven't turned the corner from a profitability standpoint, and we think that's also going to provide opportunities for us as we go forward in looking at new markets and new partners that want to expand and need that help," he said.
"Disrupting" the status quo of care
Coming out of the COVID-19 pandemic, as patients and consumers embraced telehealth options and other alternative sites of care, it became clear that providers needed to reevaluate their strategies. And, traditional providers like hospitals and health systems have been feeling the heat from new players like Amazon, Walgreens and digital health companies pushing into the primary care market.
"Healthcare has been a fairly fragmented system across the industry, and COVID has taught us that things need to change. We've seen 'disruptors' come into the market and a focus on making healthcare easier," Bonick said. "That's why we've focused on expanding beyond the four walls of the hospital. We've got strong positions and strong growing markets across the country, but it has been historically very inpatient-focused. It was this sort of 'We built it and you must come' strategy. Well, COVID has taught us that patients have choices. They don't have to come to the hospital for care. So, if we can emulate what the disrupters have tried to do and disrupt ourselves, I think we're going to be putting ourselves in a better position for the patient's perspective for the long term."
Investments in virtual care are part of that strategy, he added. "All of our clinics across the company have on-demand access to video visits, so we can do the same thing that Amazon's doing, but unlike with Amazon, we're able to connect you to that next level of care," he said.
Investing in tech capabilities
In 2021, Ardent Health, when it was still a private company, completed an implementation of a single systemwide instance of Epic’s electronic health record technology throughout all of its facilities. The health system called out this tech capability in its S-1 filing with the Securities and Exchange Commission when it went public, noting that it's a key differentiator and makes the provider "a more attractive partner for emerging technology providers and facilitates physician use of novel technology."
"I don't know if there is another large investor-owned company that's got one EHR system, let alone using Epic. That was a big undertaking," Bonick said.
Ardent's systemwide use of Epic also provides uniformity of data and facilitates interconnected patient care across the continuum of its clinics, hospitals and other care settings, including the home, executives said.
That one instance of Epic serves as Ardent Health's "clinical operating system backbone," Bonick noted. "It's our scheduling system. It integrates with our clinics and our hospitals, so we've got seamless interaction. For our patients, they've got one place that they can go, one source of truth, where they can see all of their healthcare needs and have easy access to that. It's an operational tool. It's a quality tool. It's a patient- and consumer-facing tool that really just brings the entire system together," he said.
The acquisition of nine urgent care centers in its East Texas and Kansas markets last year marks a "preamble of what's to come," Bonick said.
"All of our physicians, clinics and office locations, our outpatient locations, our hospitals, are on this one instance of Epic. As we integrate NextCare, we'll be adding them onto our Epic platform, and that gives people the opportunity to schedule care, when and where they need it the most, and we'll be able to have insights on those patients," he said.
In its East Texas market, with the acquisition of additional urgent care clinics, about 30% of the patients that are coming to those facilities are brand-new to Ardent Health, he noted. "That's an opportunity to engage with those patients, and we know that a smaller double-digit percentage of those patients are going to need follow-up care, so we're able to schedule them into a specialist before they leave that urgent care, or if they need a lab test or an imaging study or a procedure done, we're going to be able to help them and just make that seamless continuum of care for them, so they don't have to go to 'Dr. Google' and look for that next referral when they need it," Bonick said.
Ardent Health's JV model
The company reported $5.4 billion in total revenue and $129 million of net income in 2023. In the third quarter of 2024, Ardent Health pulled in $1.45 billion in revenue, 5% over the prior year, and net income of $26 million. The company expects to report between $5.8 billion and $5.875 billion in total revenue for the year, according to its latest guidance. It also expects to bring in $156 million to $176 million in profit for the year.
Ardent Health executives point to the company’s “well-established and differentiated” joint venture model in which it partners with major nonprofit systems or academic medical centers as a key competitive advantage. The company partners with UT Health East Texas and Hackensack Meridian Medical, among many others.
"It allows us to form partnerships with either local nonprofits or academic systems, mostly the academic side, and we're able to help them to expand that network visibility. If we look at our academic partners, they've got great name recognition, but they want to continue to grow across their state footprint. For us to partner, we're able to bring what we do best, which is managing hospitals and health systems, capitalize on their brand and build something that's bigger than they're able to do on their own. It's been a great model for us to be able to expand for the company," Bonick said.