Case Study: Major Healthcare Payer Receives Due Diligence on Potential ASC Partnership

Case Study: Major Healthcare Payer Receives Due Diligence on Potential ASC Partnership

Avanza capabilities at work: Due Diligence, Feasibility Assessment


To develop an lower cost option for its constituents, a large healthcare payer was considering whether to invest in an ambulatory surgery center (ASC) development and management company with bundled payment expertise. The organization focused on developing collaborations for bundled surgical services in the ASC market. The payer and ASC developer had an existing working relationship, but both parties were interested in formalizing ties through an investment in the company and/or a partnership arrangement.


Avanza Healthcare Strategies was brought it by the law firm representing the payer to perform the following due diligence tasks:

  • Provide a detailed evaluation of the competencies and capabilities of the ASC company's development and management services. This, included assessing the organization's depth of knowledge of ASC industry best practices and its capacity to undertake a successful expansion strategy.
  • Serve as the ASC subject matter expert to the payer throughout the due diligence period, including advisory involvement in discussions about the ASC company's financial valuation.

Avanza was selected to provide these services because of its long history of serving the ASC industry, intimate understanding of bundled payments and the challenges of bringing them to market, and extensive experience with ASC management and development.


  • Conducted interviews with the ASC company's leadership and personnel, including an on-site visit to the ASC company's office.
  • Reviewed case volumes of the ASC company's bundled payment program to determine growth opportunities.
  • Compared operations at the company's managed centers relative to ASC industry benchmarks to determine the effectiveness of their management services.
  • Provided an objective review of the ASC company's valuation by analyzing the valuation report and participating in calls with the payer and the investment bank responsible for developing the document.
  • Coordinated regularly with the payer to ensure work performed was meeting needs and expectations.


Avanza's due diligence services helped to validate the qualifications of the ASC company leadership. The go-forward relationship seeks to leverage the ASC company's capabilities to develop ASCs with bundled payment networks in the payer's membership community. Avanza has remained in contact with the payer and may be contracted to provide additional due diligence and advisory services as the partnership progresses.