Ascension Saint Thomas is moving toward the acquisition of Williamson Health, an independent nonprofit healthcare system serving one of Middle Tennessee’s fastest-growing counties.

The Williamson Health Board of Trustees unanimously selected Ascension Saint Thomas following a two-year strategic review of the Franklin-based system’s long-term capital requirements and ownership options. The proposal carries an estimated economic value approaching $1 billion, although several negotiation and approval steps remain before a transaction can be completed.

Under the proposed terms, Ascension Saint Thomas would pay $700 million for Williamson Health and invest another $250 million in the system over the following 10 years. The capital commitment is expected to support facility improvements, new medical technology, electronic health record upgrades and the expansion of clinical service lines.

The proposed acquisition would encompass Williamson Health’s entire portfolio, including its real estate, equipment, employees and operating entities. Those assets include Williamson Medical Center, the Bone and Joint Institute of Tennessee, Williamson Health Medical Group, outpatient imaging and laboratory operations, emergency medical services and the Williamson Health Foundation.

Williamson Health operates more than 30 locations and employs over 2,400 people. Its network includes more than 900 physicians and advanced practice providers representing over 60 medical specialties and subspecialties.

The organization’s board began evaluating its future structure after determining that Williamson Health would require approximately $150 million in additional capital during the next five years, followed by continued investment thereafter. Although the system remains financially stable, trustees concluded that remaining independent could restrict its ability to expand services and respond to changing reimbursement models, workforce pressures and growing community demand.

Ascension Saint Thomas was selected over competing proposals from HCA Healthcare and Optum. Both Ascension and HCA reportedly offered purchase prices of $700 million, but Ascension proposed a larger long-term capital commitment. Optum presented a management and outsourcing arrangement that would have allowed Williamson Health to retain independent governance rather than complete a sale.

Ascension has also proposed maintaining Williamson Health’s existing clinical services for at least 10 years. Current employees would remain in place for at least one year following the transaction, while compensation would be maintained at comparable levels. Existing charity-care commitments, community programs and clinical partnerships are also expected to continue.

The parties will next prepare a nonbinding letter of intent for consideration by the Williamson County Commission. A definitive purchase agreement would then require additional county and regulatory approvals.

Williamson Health will continue operating independently while the process moves forward. Officials anticipate that the transaction could close in 2027 or 2028.

Following the sale, proceeds would first be applied to Williamson Health’s outstanding debt, transaction expenses and other closing obligations. The Williamson County Commission would determine how the remaining funds are allocated.

Source: FierceHealthcare