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This is the strategist in brief for June 20th, 2025. Our first market scan covers some breaking news. Ascension Health announced an agreement to acquire a SC operator AmSurg for an undisclosed amount with earlier reports suggesting a possible purchase price of$3.9 billion. AmSurg operates more than 250 ASC across 34 states, partnering with over 2000 physicians. Ascension has shed many of its underperforming and non-core hospital assets over the past year and appears to be rebalancing its portfolio towards outpatient care. Their strategy recalls similar moves made by tenant health with USPI two and three-way JVs between operators. Health systems and physician groups are increasingly common. Some health systems are going on the offensive in a fragmented market amid heightened competition. Ascension's approach comes with risks as it transitions from a capital light partnership driven growth model to one that requires greater operational oversight, financial risk, and brand management across hundreds of sites. And now onto our next market scan, AZE Health, a virtual cardiology model developed by MedStar Health has officially launched commercially. The company expands cardiology practices by leveraging remote advanced practice providers who handle low acuity visits and administrative functions. Like many specialties, cardiology faces challenges with rising patient demand, increasing clinical complexity, and persistent workforce shortages. Scaled virtual models like Azera might be able to modernize service delivery without fragmenting care. Ox Sierra's development through Abundant Venture partners highlights the potential for collaborative investment among health systems. In other news, you should know Amazon is dividing its healthcare segment into six new business units. Just weeks after several key executives announce their departures. A more focused and accountable structure might help Amazon more fully realize its healthcare ambitions, but it could also be a reactive strategic pivot in response to uneven progress. Amazon's push to assemble a vertically integrated healthcare enterprise raises strategic questions for health systems that partner with one medical. Especially as the company seeps to capture more prescription volume through Amazon Pharmacy. And now our final news item, virtual Weight Management and Diabetes Care Disruptor. Virta Health's new direct to employer offering features a financial guarantee to limit GLP one utilization growth. The offering competes head to head with health system direct to employer programs and might be better positioned to scale nationally making attractive to large national employers and health plans. Health systems can lean into competitive strengths, like in-person services, multidisciplinary teams, access to specialists and local reputations. That concludes this week's edition. Be sure to check out the full version on the web@hmacademy.com. Thanks for listening.