Health systems and physician-led pain and spine platforms are both acquiring independent spine practices in 2026, and the pace picked up in July. Financial terms were not disclosed in any of the practice transactions below.
Here are six deals and market signals to know.
1. A nonprofit system picked up a 100-provider group in July: Sioux Falls, S.D.-based Avera Health acquired The Center for Neurosciences, Orthopaedics & Spine, a physician-owned multispecialty group in Dakota Dunes, S.D.
The deal brings more than 100 physicians, advanced practice providers, physical therapists, occupational therapists and athletic trainers across nine specialties, plus more than 350 staff and eight clinic locations. Specialties include orthopedics, neurosurgery, neurology, gastroenterology, general surgery, dermatology, rheumatology, podiatry and occupational medicine.
The acquisition closes Jan. 1, 2027, when the group will be renamed Avera CNOS. The practice formed in the 1990s and provides outreach services to 29 satellite locations across South Dakota, Iowa and Nebraska, per the release.
2. Health systems have been the most aggressive buyers of large spine and neurosurgery groups: The Avera deal follows a pattern Becker’s has tracked across the past two years. Charlotte, N.C.-based Atrium Health absorbed Carolina NeuroSurgery & Spine Associates, one of the largest independent neurosurgery groups in the country. New York City-based NYU Langone Health acquired Rothman Orthopaedics of Greater New York and Rothman Orthopaedics in New York City.
Orthopedics remains among the most aggressively pursued specialties in physician dealmaking because of its high outpatient procedure volume and strong commercial reimbursement.
3. A pain and spine platform now operates 21 ASCs across five states: Thomasville, Ga.-based Summit Spine & Joint Centers acquired Southeast Neurology & Pain Management, an interventional pain practice with clinics in Thomasville, Tallahassee, Fla., and Panama City, Fla., according to a July 14 news release.
The deal was Summit’s third practice acquisition in three years and expands its footprint to 55 clinics and 21 ASCs across Georgia, Florida, North Carolina, South Carolina and Tennessee.
4. Private-equity-backed managers are pitching autonomy rather than employment: Elgin, Ill.-based DxTx Pain and Spine partnered with SEPA Pain & Spine, a seven-physician practice in Horsham, Pa., in a March 3 deal advised by Cross Keys Capital. The practice performs spinal injections, nerve blocks and spinal cord stimulation.
DxTx secured a $50 million commitment from BC Partners Credit in 2023, when it operated 60 locations. The platform markets a model that preserves physician ownership and practice identity, a contrast to the employed-physician structure health systems offer.
5. Smaller regional platforms are competing for the same practices: Atlanta-based Resolve Pain Solutions acquired Southcoast Spine and Pain in Aiken, S.C., in a March 9 deal. Pain management physician Russell Daniel, MD, joined the platform and will also see patients at Resolve’s practice in Evans, Ga.
6. Supply is unusually heavy, and Medicare’s 2027 proposals explain the timing: Six large orthopedic groups were actively going to market in 2026, more than in 2025, Dana Jacoby, president and CEO of Vector Medical Group, told Becker’s. Her firm advises physician groups on transactions. The first wave of orthopedic roll-ups from 2021 and 2022 is reaching maturation, and second bites and continuation funds are reshaping what an exit looks like.
The reimbursement backdrop pushes in the same direction. CMS’ proposed CY 2027 physician fee schedule, released July 14, cuts the conversion factor 1.68% to $32.8409. The companion outpatient and ASC rule proposes a 2.4% facility increase, an ASC conversion factor of $57.766 and roughly 618 additions to the ASC covered procedures list.
That split rewards ownership of facilities over professional fees, which is the asset most spine and pain platforms are assembling. Comments on both rules are due Aug. 31.
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