The healthcare industry is experiencing a significant increase in mergers and acquisitions (M&A) activity, with 27 hospital transactions announced in the third quarter of 2024. This is the highest volume for Q3 since 2017.
The surge in activity is largely due to the bankruptcy of Steward Health Care, which has driven nearly half of the transactions during this period. The total revenue transacted in these deals reached $13.3 billion, highlighting the scale of consolidation in the healthcare sector.
One notable transaction linked to the Steward bankruptcy is Health Care Systems of America's acquisition of operations at eight hospitals across Florida, Louisiana, and Texas. This deal is classified as one of four "mega mergers" for the quarter, where the annual revenue of the smaller party exceeds $1 billion.
Other significant mergers include Orlando Health's acquisition of Brookwood Baptist Health in Alabama, Prime Healthcare's planned acquisition of eight Ascension-owned hospitals in Illinois, and the proposed combination of Sanford Health and Marshfield Clinic Health System. These transactions reflect a broader trend of large national health systems strategically adjusting their portfolios to meet evolving community needs and capitalize on new opportunities.
Despite the high volume of transactions, many financially struggling organizations are finding it challenging to find suitable partners. The ongoing financial strain on numerous hospitals has raised concerns about potential closures, particularly in light of the Steward Health Care bankruptcy.
State governments in Arizona and Massachusetts have expressed appreciation for established health systems willing to take on struggling hospitals, emphasizing the urgent need for partnerships to ensure the survival of these institutions.
The average size of the seller in these transactions has significantly decreased, indicating that many smaller, financially distressed organizations are at risk of being left without viable options. This decline in average seller size is consistent with recent year-end averages, excluding the exceptionally high figures seen in 2021 and 2022.
Larger health systems are actively pursuing acquisitions, while smaller organizations face increasing risks.
The high level of announced transactions in Q3 2024 reflects a return to a more normalized level of M&A activity following a period of uncertainty. However, it also highlights the significant number of financially struggling hospitals that are unable to secure partnerships, potentially leading to closures. The healthcare sector is experiencing ongoing consolidation as organizations adapt to the changing dynamics and seek to enhance their operational efficiencies.