Constitution Surgery Alliance

What Constitution Surgery Alliance does

Constitution Surgery Alliance (CSA) is an independent developer and operator of ambulatory surgery centers (ASCs), founded in 1998 and headquartered in Avon, Connecticut. The company provides turnkey ASC development services (physician recruitment and syndication, financial feasibility, site selection, construction management, licensure, and accreditation) and ongoing operational management (HR, OR scheduling, managed care contracting, regulatory compliance, risk management). It complements these core services with revenue cycle management through a wholly-owned subsidiary, Constitution Billing & Financial Services, LLC, plus a discrete strategic advisory practice covering market analysis, physician alignment, and feasibility modeling. A proprietary business intelligence system and the CSA Registry Program for orthopedics aggregate clinical, financial, and patient-reported outcome data across the network.

CSA serves three primary constituencies: more than 400 partnered physicians and surgeons, hospital and health system partners (notably Hartford HealthCare across five joint-venture ASCs, plus relationships with OrthoVirginia/VHC Health, Lancaster Orthopedic Group, St. Anne's/Brown University Health, and others), and ultimately patients receiving outpatient surgical care. The company manages 16 facilities encompassing 80+ operating rooms across five states (Connecticut, Massachusetts, Rhode Island, Virginia, and Pennsylvania) with expansion into New York slated for February 2026; partnered centers collectively perform 90,000-100,000+ procedures annually. CSA has developed 26 ASCs since inception, 15 of which are hospital joint ventures.

The business model is fee-based B2B services delivered through joint-venture partnerships with physician groups and health systems, with revenue derived from development fees, ongoing management services, revenue cycle contracts, and strategic advisory engagements. In June 2025, CSA received a strategic growth investment from Welsh, Carson, Anderson & Stowe (WCAS) to support national expansion. The company has earned 17 Leapfrog Top ASC designations since 2022 and maintains accreditations from AAAHC and The Joint Commission across partnered facilities.

Name

Constitution Surgery Alliance

Legal name

Constitution Surgery Alliance

Website

https://csasurgery.com

Company type

Private

Founded year

1998

Operating status

Operating

Headcount range

51–100 employees

Short description

Constitution Surgery Alliance (CSA) is an independent developer and operator of ambulatory surgery centers, founded in 1998 and managing 16 facilities across five states with 80+ operating rooms. It serves physician groups and health systems through joint-venture partnerships spanning turnkey development, operational management, revenue cycle services, and strategic advisory.

Ownership category

akta.pro rank

Product category

Ambulatory Surgery Center Services

NAICS

Offices of Physicians (62111)

SIC

Services-Specialty Outpatient Facilities, Nec (8093), Services-Health Services (8000)

akta.pro primary industry

Multi-Specialty Ambulatory Surgery Centers (ASCs) (HLAFAIAA)

akta.pro secondary industries

Orthopedic & Spine Surgery Centers (HLAFAIAG), Ophthalmology Surgery Centers (HLAFAIAF), Pain Management & Interventional Procedure Centers (HLAFAIAH)

Keywords

• Ambulatory surgery centers
• ASC development services
• ASC management services
• Outpatient surgical facilities
• Surgical joint ventures

Headquarters

HQ city

Avon

HQ country

United States

HQ region

North America

Offices18 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Infrastructure, Marketing or Sales, Technology or R&D, Supply Chain

Revenue model

1. ASC Development Services: Turnkey outpatient surgery center development services including physician recruitment, financial feasibility analysis, project budgeting, construction management, licensure, and accreditation
2. ASC Management Services: Daily operational oversight of ambulatory surgery centers including HR support, OR scheduling, managed care contracting, vendor contracting, regulatory compliance, and risk management
3. Revenue Cycle Management Services: Billing and collections, certified coding, accounts receivable management, contract management, and financial reporting provided through Constitution Billing & Financial Services, LLC
4. Strategic Advisory Services: Market and situational analysis, revenue/payer assessments, physician alignment solutions, acquisition plans, and project feasibility analysis

Go-to-market motion1 record

Distribution channels3 records

Marketing channels4 records

Core offering

Constitution Surgery Alliance (CSA) develops, owns, and operates ambulatory surgery centers (ASCs) through turnkey partnerships with physicians and health systems. Core offerings include turnkey ASC development (physician recruitment, financial feasibility, construction, licensure, accreditation), turnkey ASC management (daily operations, OR scheduling, managed care contracting, compliance), revenue cycle management and billing services via Constitution Billing & Financial Services, LLC, and strategic advisory services for new and existing ASCs.

Product overview

Constitution Surgery Alliance (CSA) is a healthcare services company and not a software product company. CSA operates a portfolio of 16 ambulatory surgery centers (ASCs) across five states and provides turnkey ASC development and management services to physician and health system partners. The core offerings include Turnkey ASC Development (full-service development from concept through licensure), Turnkey ASC Management (daily operations oversight), Revenue Cycle Management (billing and financial services via Constitution Billing & Financial Services, LLC), and Strategic Advisory Services. Additionally, CSA offers a Proprietary Business Intelligence System that provides clinical, strategic, and financial insights. These services work together to support the complete lifecycle of outpatient surgery center operations.

Differentiator

Problem solved

Functional benefit

Products and services

• Turnkey ASC Development Comprehensive development services for ambulatory surgery centers including physician recruitment and syndication, financial feasibility analysis, project budgeting, legal entity formation, site selection, property acquisition, lease negotiations, project financing, certificate of need processing, facility design, staffing plans, construction management, equipment procurement, and state licensure, Medicare certification, and national accreditation.
• Turnkey ASC Management Day-to-day operational management services for ambulatory surgery centers including operational oversight, HR support, OR scheduling, physician recruitment, managed care contracting, vendor contracting, strategic planning, partner meeting facilitation, regulatory compliance, risk management, and credentialing.
• Revenue Cycle Management Complete billing and financial services for ambulatory surgery centers including accrual and cash basis financial reporting, regional and national benchmarking, group purchasing contracts, comprehensive billing and collections, IT support, single case agreements, certified coding, supply chain management, accounts payable, budgeting and financial analysis, payer contract modeling and negotiations, ASC billing services, coding audits, payroll, and benefit administration. Provided under separate contract with Constitution Billing & Financial Services, LLC.
• Strategic Advisory Services Advisory services for physician groups and health systems including market and situational analysis, revenue and payer assessments, physician alignment solutions, acquisition plans, and project feasibility analysis and scenario modeling.

Quantifiable outcome

• CSA partners with more than 400 physicians and has developed 26 surgery centers since 1998
• +5 more outcomes

Named customers7 records

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Eight partnerships are on record, tiered core.

• Hartford HealthCarecoreStrategic or Co-development PartnerMultiple joint venture ASCs including Cheshire Surgery Center, Hartford Surgery Center, Rocky Hill Surgery Center, Southwest Connecticut Surgery Center, and Connecticut Orthopaedic Surgery Center. CSA structures innovative partnerships with this fully integrated health system of six acute care hospitals.
• Orthopedic Associates of HartfordcoreStrategic or Co-development PartnerLong-term strategic partnership since 2003 with multiple ASCs. OAH has grown from 16 MD group to 34 MD group with three ASCs in portfolio, performing over 17,000 surgeries annually within partnered ASCs.
• Constitution Billing & Financial Services, LLCcoreStrategic or Co-development PartnerSeparate contract entity providing complete Revenue Cycle and Financial Services including billing, coding, accounts receivable management, and financial reporting for CSA-affiliated ASCs since 2008.
• Middlesex Gastroenterology AssociatescoreStrategic or Co-development PartnerJoint venture partnership for Middlesex Endoscopy Center, a 7,500 sqft facility with 3 procedure rooms in Middletown, CT, accredited by AAAHC.
• Lancaster Orthopedic GroupcoreStrategic or Co-development PartnerJoint venture for Lancaster Orthopedic Group Surgery Center specializing in orthopedics, spine, and joint replacement in Lancaster, PA.
• OrthoVirginia and VHC HealthcoreStrategic or Co-development PartnerJoint venture for McLean Tysons Orthopedic Surgery Center with physicians from OrthoVirginia and VHC Health, a 16,000 sqft orthopedic specialty center in McLean, VA.
• St. Anne's Hospital, Brown University HealthcoreStrategic or Co-development PartnerHospital Outpatient Department partnership for Southern New England Surgery Center, a 25,000 sqft multi-specialty center with 8 operating rooms in Attleboro, MA, accredited by The Joint Commission.
• Guthrie Broome Orthopedic and Spine Surgery CentercoreStrategic or Co-development PartnerFeatured partnered center in Johnson City, NY specializing in orthopedics and total joint replacements. New ASC nearing completion with advanced surgical technology opening February 2026.

Scale indicators14 records

Recent moves7 records

Expansion highlights6 records

Broad incumbents

• HCA Healthcare: One of the largest U.S. hospital operators with an ASC strategy and physician partnership network. CSA's CDO Rod Carbonell previously held leadership roles at HCA, making this a clear career-lineage competitor with overlapping orthopedic and ASC priorities.
• Tenet Healthcare: Hospital operator that owns USPI; competes indirectly with CSA through USPI's ambulatory arm. Comparable through ASC development and physician alignment strategies, but Tenet is a much larger diversified health system.
• Optum (UnitedHealth Group): Healthcare services arm of UnitedHealth Group with growing ASC and outpatient surgery exposure through acquisitions. Larger and more diversified than CSA but increasingly competes for the same physician groups and outpatient surgical volumes.

Direct peers

• ASD Management: ASC management company providing turnkey operations support to physician-owned surgery centers. Directly comparable to CSA's management services offering, though typically working with smaller freestanding centers rather than hospital JVs.
• Compass Surgical Partners: Independent ASC management and development company operating hospital JVs and freestanding ASCs across the U.S. Direct competitor to CSA in turnkey ASC development, hospital joint ventures, and physician partnership models.
• SurgCenter Development: Private ASC developer and operator with a hospital JV and physician partnership model similar to CSA's. Overlapping specialty mix (orthopedics, spine, ophthalmology) and operating geographies in the Eastern U.S.
• Surgery Partners: Public ASC operator (NASDAQ: SGRY) with ~300+ facilities across 30+ states. Closest direct competitor to CSA in terms of hospital JV model, multi-specialty platform, and orthopedic focus. Comparable revenue scale and physician partnership approach.
• United Surgical Partners International (USPI): Largest U.S. ASC operator with ~400+ facilities; a Tenet Healthcare subsidiary. Directly comparable to CSA in developing and managing ambulatory surgery centers through hospital and physician JVs. CSA's Chief Growth Officer James Jackson spent 22 years at USPI.

Emerging players

• ValueHealth: Value-based surgical care platform developing ASCs and bundled-payment programs. CSA's CDO Rod Carbonell previously served as President, creating direct personnel overlap; comparable in orthopedic and ASC focus but newer and more bundled-payment oriented.
• Muve Health: Orthopedic-focused ASC operator with bundled-payment model. CSA's CDO previously served as President of Muve, indicating direct executive and operational overlap in the orthopedic ASC segment.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks5 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/constitution-surgery-centers

Revenue estimate

Valuation estimate

Number of profiles

Profiles21 records

Subsidiaries1 record

Funding overview

Funding rounds1 record

Investors1 record

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Constitution Surgery Alliance